OCC OCC Pharmacology & Therapeutics 1 — Questions and Answers
Question 1: A DO prescribes a patient metformin for type 2 diabetes. Which mechanism of action best describes metformin?
- Decreases hepatic glucose production and improves insulin sensitivity (Correct answer)
- Stimulates pancreatic beta cells to release insulin
- Blocks glucose reabsorption in the renal tubule
- Inhibits alpha-glucosidase to slow carbohydrate absorption
Correct answer: Decreases hepatic glucose production and improves insulin sensitivity
Metformin primarily works by activating AMPK to reduce hepatic gluconeogenesis and increase peripheral insulin sensitivity.
Question 2: Which drug interaction results in increased risk of bleeding when warfarin is combined with aspirin?
- Additive anticoagulant and antiplatelet effect increases hemorrhagic risk (Correct answer)
- Aspirin decreases warfarin metabolism causing toxicity
- Aspirin increases warfarin protein binding reducing effect
- Warfarin inhibits aspirin absorption
Correct answer: Additive anticoagulant and antiplatelet effect increases hemorrhagic risk
Warfarin inhibits clotting factors while aspirin inhibits platelet aggregation — combined use additively increases bleeding risk.
Question 3: A patient on a fluoroquinolone antibiotic develops tendon pain. Which tendon is most commonly affected?
- Achilles tendon (Correct answer)
- Patellar tendon
- Rotator cuff
- Biceps tendon
Correct answer: Achilles tendon
Fluoroquinolone antibiotics carry a black box warning for Achilles tendon rupture, with the Achilles being the most commonly affected tendon.
Question 4: Which class of antihypertensive medication is contraindicated in bilateral renal artery stenosis?
- ACE inhibitors and ARBs (Correct answer)
- Beta-blockers
- Calcium channel blockers
- Alpha-blockers
Correct answer: ACE inhibitors and ARBs
ACE inhibitors and ARBs reduce efferent arteriolar tone, which drops GFR critically in bilateral renal artery stenosis where GFR depends on angiotensin II.
Question 5: Which Schedule II controlled substance requires a written or electronic prescription and cannot be refilled?
- Oxycodone (Correct answer)
- Hydrocodone combination products (low dose)
- Tramadol
- Carisoprodol
Correct answer: Oxycodone
Oxycodone is Schedule II; prescriptions cannot be refilled and require a new written or e-prescribe for each fill.
Question 6: A patient taking a statin develops myalgias with markedly elevated CK levels. What is the most appropriate next step?
- Discontinue the statin immediately and monitor renal function (Correct answer)
- Reduce the dose and continue therapy
- Add CoQ10 and continue the statin
- Switch to a higher potency statin
Correct answer: Discontinue the statin immediately and monitor renal function
Markedly elevated CK with myalgia suggests statin-induced myopathy/rhabdomyolysis — the statin must be stopped immediately to prevent acute kidney injury.
OCC OCC Pharmacology & Therapeutics 1
A DO prescribes a patient metformin for type 2 diabetes.
Which mechanism of action best describes metformin?