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.
Read the first 7 Treatment Planning flashcards as text
A patient taking phenytoin for seizures is prescribed fluconazole for a fungal infection. What is the expected pharmacokinetic outcome?
Answer: Fluconazole inhibits CYP2C9, increasing phenytoin levels and toxicity risk
Fluconazole is a potent CYP2C9 inhibitor; since phenytoin is primarily metabolized by CYP2C9, co-administration can lead to significantly elevated phenytoin levels and toxicity.
A child with otitis media has a penicillin allergy documented as 'hives and swelling.' What antibiotic is the most appropriate alternative?
Answer: Azithromycin, to avoid all beta-lactams due to severe allergy history
Hives and swelling suggest a possible IgE-mediated reaction; avoiding all beta-lactams and choosing azithromycin is the safest approach in this clinical context.
A patient is prescribed methotrexate for rheumatoid arthritis. What supplement should ALWAYS be co-prescribed to reduce toxicity?
Answer: Folic acid 1–5 mg daily
Folic acid supplementation significantly reduces methotrexate-associated adverse effects such as mucositis, nausea, and hepatotoxicity without diminishing its therapeutic efficacy.
When selecting an antibiotic for a urinary tract infection (UTI) in a patient with a sulfonamide allergy, which commonly used UTI agent must be avoided?
Answer: Trimethoprim-sulfamethoxazole (TMP-SMX)
TMP-SMX contains sulfamethoxazole, a sulfonamide antibiotic, and must be avoided in patients with documented sulfonamide allergy.
A patient newly diagnosed with type 2 diabetes has an A1C of 9.5% and is otherwise healthy. According to Canadian Diabetes Association guidelines, what is the preferred initial pharmacotherapy?
Answer: Metformin plus a second agent due to high A1C unlikely to be controlled with monotherapy
Canadian guidelines recommend combination therapy at diagnosis when A1C is ≥1.5% above target, as monotherapy is unlikely to achieve glycemic goals in this scenario.
Which parameter best determines whether a patient requires a loading dose when initiating a new medication?
Answer: A large volume of distribution requiring more drug to achieve therapeutic concentrations quickly
A large volume of distribution means drug is extensively distributed into tissues, requiring a loading dose to rapidly achieve therapeutic plasma concentrations without waiting for steady state.
A breastfeeding mother requires treatment for mild-to-moderate postpartum depression. Which antidepressant is generally considered the preferred choice due to its safety profile in breastfeeding?
Answer: Sertraline, due to low milk-to-plasma ratio and extensive safety data
Sertraline has low transfer into breast milk and the most extensive safety data in breastfeeding, making it the first-line choice for postpartum depression.