PEBC Treatment Planning 3

Question 1

A 30-year-old woman with epilepsy on valproic acid 1000 mg/day is planning a pregnancy. What is the pharmacist's MOST important recommendation?

Accepted Answer

Switch to levetiracetam before conception and start high-dose folic acid 5 mg/day

Answer

Valproic acid carries the highest teratogenic risk among antiepileptics; pre-conception transition to a safer agent plus high-dose folic acid (5 mg/day) is strongly recommended.

Question 2

A patient with community-acquired pneumonia (CAP) and no comorbidities is treated in an outpatient setting. Per Canadian guidelines, what is the preferred first-line treatment?

Accepted Answer

Doxycycline 100 mg BID for 5–7 days or amoxicillin 1 g TID

Answer

Canadian guidelines recommend amoxicillin or doxycycline as first-line for outpatient CAP in otherwise healthy patients without recent antibiotic use.

Question 3

A pharmacist identifies that a patient on lithium for bipolar disorder has started ibuprofen regularly for arthritis pain. What is the primary concern?

Accepted Answer

NSAIDs decrease renal clearance of lithium, raising serum levels toward toxicity

Answer

NSAIDs inhibit prostaglandin-mediated renal blood flow, reducing lithium clearance and potentially causing lithium toxicity.

Question 4

A 72-year-old patient is prescribed temazepam for insomnia. What Beers Criteria concern should the pharmacist raise?

Accepted Answer

Benzodiazepines increase risk of cognitive impairment, falls, and motor vehicle accidents in older adults

Answer

The Beers Criteria lists benzodiazepines as potentially inappropriate in older adults due to increased sensitivity and risks of falls, fractures, and cognitive impairment.

Question 5

A patient with active tuberculosis is started on standard RIPE therapy. Which combination of adverse effects should the pharmacist monitor for with rifampin?

Accepted Answer

Orange discoloration of body fluids and drug-drug interactions via CYP450 induction

Answer

Rifampin is a potent CYP450 inducer causing numerous drug interactions, and it characteristically turns urine, tears, and sweat orange.

PEBC - Pharmacy Examining Board of Canada Practice Test

PEBC - Pharmacy Examining Board of Canada Practice Test

PEBC Treatment Planning 3