PEBC Treatment Planning 5

Question 1

A patient with HIV is initiated on an antiretroviral regimen containing tenofovir disoproxil fumarate (TDF). Which organ function requires close monitoring?

Accepted Answer

Renal function (serum creatinine, eGFR) and bone density

Answer

TDF is associated with nephrotoxicity and decreased bone mineral density; renal function and bone density monitoring are key components of TDF-based regimen follow-up.

Question 2

A 60-year-old man with gout has a serum uric acid of 620 µmol/L and recurrent flares. He is started on allopurinol. What is the most important counselling point about starting allopurinol?

Accepted Answer

Gout flares may paradoxically increase in the first months of therapy; prophylactic colchicine or NSAID is recommended

Answer

Mobilization flares commonly occur when starting urate-lowering therapy as urate crystals are mobilized; low-dose colchicine or NSAID prophylaxis for 3–6 months is recommended.

Question 3

A pharmacist is assessing a patient's medication adherence. The patient reports taking their antihypertensive medications only 3–4 days per week. What is the MOST appropriate first intervention?

Accepted Answer

Explore barriers to adherence through motivational interviewing before modifying the regimen

Answer

Identifying and addressing patient-specific barriers through motivational interviewing is the foundational first step before making any therapeutic changes.

Question 4

A patient on amiodarone for atrial fibrillation is also taking warfarin. What adjustment to warfarin dosing is typically required?

Accepted Answer

Reduce warfarin dose by approximately 30–50% as amiodarone inhibits its metabolism

Answer

Amiodarone inhibits CYP2C9 (and CYP3A4), significantly reducing warfarin metabolism and increasing INR; warfarin dose reduction of 30–50% is typically required.

Question 5

A 45-year-old patient with moderate persistent asthma continues to have frequent symptoms despite low-dose ICS. What is the recommended step-up therapy per GINA guidelines?

Accepted Answer

Add a long-acting beta-2 agonist (LABA) to the existing ICS

Answer

GINA guidelines recommend adding a LABA to ICS (forming an ICS/LABA combination) as the preferred step-up for uncontrolled moderate persistent asthma.

PEBC - Pharmacy Examining Board of Canada Practice Test

PEBC - Pharmacy Examining Board of Canada Practice Test

PEBC Treatment Planning 5