Clinical Pharmacy and Patient Care Flashcards
6 cards from real Pharm.D. Doctor of Pharmacy practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Clinical Pharmacy and Patient Care flashcards as text
Which parameter is used to assess kidney function most commonly in clinical practice for drug dosing?
Answer: Creatinine clearance (CrCl) estimated by Cockcroft-Gault
The Cockcroft-Gault equation is the most widely used method to estimate creatinine clearance for drug dosing adjustment in clinical practice.
A patient on warfarin is started on ciprofloxacin. What interaction should the clinical pharmacist anticipate?
Answer: Increased INR due to reduced warfarin metabolism and gut flora suppression
Ciprofloxacin inhibits CYP1A2 and suppresses gut flora that produce vitamin K, leading to increased warfarin effect and elevated INR.
Which medication reconciliation step is MOST critical at hospital discharge?
Answer: Comparing discharge medications to pre-admission medications and counseling the patient
At discharge, comparing the new medication list to pre-admission medications and counseling the patient prevents inadvertent duplication, omission, or errors.
Which clinical pharmacy service is MOST associated with reducing hospital readmissions for heart failure patients?
Answer: Medication therapy management (MTM) and adherence counseling
MTM with adherence counseling helps heart failure patients understand their complex regimens, improving adherence and reducing readmissions.
A patient presents with signs of digoxin toxicity. Which electrolyte abnormality most potentiates this toxicity?
Answer: Hypokalemia
Hypokalemia potentiates digoxin toxicity because low potassium increases digoxin binding to Na+/K+-ATPase, enhancing its toxic effects.
In anticoagulation management, which lab value is used to monitor unfractionated heparin therapy?
Answer: aPTT
Activated partial thromboplastin time (aPTT) is the standard laboratory test used to monitor unfractionated heparin therapy, targeting 1.5–2.5 times the control value.