NCCPA Pharmacology 4

Question 1

A patient taking clozapine develops a fever, sore throat, and absolute neutrophil count of 400/µL. What is the appropriate action?

Accepted Answer

Discontinue clozapine immediately and monitor CBC

Answer

An ANC below 500/µL indicates agranulocytosis, the most serious adverse effect of clozapine, and the drug must be immediately stopped.

Question 2

Which medication used for alcohol use disorder causes an aversive reaction when alcohol is consumed by blocking aldehyde dehydrogenase?

Accepted Answer

Disulfiram

Answer

Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation and a flushing, nausea, and tachycardia reaction when alcohol is ingested.

Question 3

Which antiarrhythmic drug prolongs QT interval the most and carries the highest risk of torsades de pointes?

Accepted Answer

Sotalol

Answer

Sotalol blocks both potassium channels (class III) and beta-adrenergic receptors, producing significant QT prolongation and torsades de pointes risk.

Question 4

A patient with Parkinson's disease on levodopa/carbidopa develops visual hallucinations. Which medication is preferred to treat psychosis while preserving motor function?

Accepted Answer

Quetiapine

Answer

Quetiapine has low D2 receptor affinity and is preferred in Parkinson's psychosis as it causes less motor worsening than high-potency antipsychotics.

Question 5

Which drug is the antidote for acetaminophen overdose and works by replenishing glutathione stores?

Accepted Answer

N-acetylcysteine

Answer

N-acetylcysteine provides cysteine for glutathione synthesis, neutralizing the toxic NAPQI metabolite of acetaminophen.

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

(NCCPA) National Commission on Certification of Physician Assistants Practice Test

NCCPA Pharmacology 4