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Treatment Planning Flashcards

7 cards from real PEBC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 68-year-old patient with type 2 diabetes and CKD stage 3 (eGFR 35 mL/min/1.73m²) is poorly controlled on metformin 1000 mg BID. Which adjustment is most appropriate?

    Answer: Discontinue metformin and initiate insulin

    Metformin is contraindicated when eGFR falls below 30 and should be used with caution below 45; at eGFR 35 with poor control, transitioning to insulin is the safest option.

  2. A patient on warfarin for atrial fibrillation requires short-term analgesia. Which agent poses the LEAST risk of significant drug interaction?

    Answer: Acetaminophen 500 mg Q6H PRN

    Acetaminophen at low-to-moderate doses is the preferred analgesic in warfarin patients as NSAIDs increase bleeding risk through antiplatelet effects and GI irritation.

  3. Which pharmacokinetic parameter is most relevant when designing a dosing regimen to maintain drug concentrations above the MIC for a time-dependent antibiotic like amoxicillin?

    Answer: Time above MIC (%T>MIC)

    Beta-lactams like amoxicillin exhibit time-dependent killing, so the pharmacodynamic target is the percentage of the dosing interval that free drug concentrations exceed the MIC.

  4. A 55-year-old woman with osteoporosis and GERD is prescribed alendronate. What counselling point is MOST critical for effective treatment?

    Answer: Take on an empty stomach with plain water and remain upright for 30 minutes

    Bisphosphonates must be taken on an empty stomach with 8 oz of plain water, and the patient must remain upright for at least 30 minutes to prevent esophageal irritation.

  5. A patient with heart failure (EF 35%) and hypertension is already on an ACE inhibitor and beta-blocker. Which additional agent has the strongest evidence for reducing mortality in this population?

    Answer: Spironolactone 25 mg daily

    Aldosterone antagonists like spironolactone have demonstrated mortality reduction in HFrEF patients already on ACE inhibitors and beta-blockers in landmark trials such as RALES.

  6. A pharmacist reviews a prescription for ciprofloxacin 500 mg BID for a patient also taking sucralfate. What is the most appropriate action?

    Answer: Recommend taking ciprofloxacin 2 hours before or 6 hours after sucralfate

    Sucralfate chelates fluoroquinolones and significantly reduces their absorption; separating administration by at least 2 hours before or 6 hours after sucralfate resolves this interaction.

  7. Which monitoring parameter is MOST important to assess within the first 1–2 weeks of initiating an ACE inhibitor in a patient with hypertension and mild CKD?

    Answer: Serum potassium and creatinine

    ACE inhibitors can cause hyperkalemia and an acute rise in serum creatinine, particularly in patients with CKD, making early electrolyte and renal function monitoring essential.