Pharm.D. Doctor of Pharmacy Drug Interactions and Adverse Effects 2

Question 1

Which adverse effect is associated with clozapine use that requires mandatory weekly or biweekly CBC monitoring?

Accepted Answer

Agranulocytosis

Answer

Clozapine is associated with life-threatening agranulocytosis (severe neutropenia), requiring mandatory CBC monitoring under the Clozapine REMS program.

Question 2

A patient on lithium develops polyuria, tremor, and confusion after starting ibuprofen. What interaction has occurred?

Accepted Answer

Ibuprofen reduces renal lithium clearance, causing lithium toxicity

Answer

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

Question 3

Which adverse effect is specifically associated with tetracycline use in children under 8 years of age?

Accepted Answer

Permanent discoloration of developing teeth and enamel hypoplasia

Answer

Tetracyclines chelate calcium and deposit in developing bones and teeth, causing permanent yellow-brown discoloration of teeth and enamel hypoplasia in children under 8.

Question 4

Serotonin syndrome is most likely to occur with which combination?

Accepted Answer

Tramadol + sertraline (SSRI)

Answer

Tramadol (has serotonergic and opioid properties) combined with an SSRI like sertraline creates excess serotonin activity, precipitating serotonin syndrome.

Question 5

QT prolongation caused by certain drugs increases the risk of which potentially fatal arrhythmia?

Accepted Answer

Ventricular fibrillation secondary to torsades de pointes (TdP)

Answer

Drug-induced QT prolongation can precipitate torsades de pointes (TdP), a polymorphic ventricular tachycardia that can degenerate into ventricular fibrillation and sudden cardiac death.

Pharm.D. Doctor of Pharmacy Practice Test

Pharm.D. Doctor of Pharmacy Practice Test

Pharm.D. Doctor of Pharmacy Drug Interactions and Adverse Effects 2