Pharm.D. Doctor of Pharmacy Doctor of Pharmacy General 2 — Questions and Answers
Question 1: A patient on warfarin starts taking fluconazole. What is the expected drug interaction?
- Decreased anticoagulant effect
- Increased INR due to CYP2C9 inhibition (Correct answer)
- No significant interaction
- Decreased fluconazole efficacy
Correct answer: Increased INR due to CYP2C9 inhibition
Fluconazole inhibits CYP2C9, reducing warfarin metabolism and increasing INR.
Question 2: Which pharmacokinetic parameter best describes the fraction of an administered drug that reaches systemic circulation unchanged?
- Volume of distribution
- Clearance
- Bioavailability (Correct answer)
- Half-life
Correct answer: Bioavailability
Bioavailability (F) is the fraction of drug that reaches systemic circulation in unchanged form.
Question 3: A patient with CrCl of 20 mL/min requires dose adjustment for which antibiotic?
- Azithromycin
- Doxycycline
- Vancomycin (Correct answer)
- Clindamycin
Correct answer: Vancomycin
Vancomycin is primarily renally eliminated and requires dose adjustment in renal impairment.
Question 4: What is the mechanism of action of metformin in type 2 diabetes?
- Stimulates insulin secretion from beta cells
- Activates PPAR-gamma receptors
- Inhibits hepatic gluconeogenesis via AMPK activation (Correct answer)
- Blocks sodium-glucose cotransporter-2
Correct answer: Inhibits hepatic gluconeogenesis via AMPK activation
Metformin activates AMPK, primarily reducing hepatic glucose production through inhibition of gluconeogenesis.
Question 5: Which adverse effect is most associated with aminoglycoside antibiotics?
- Hepatotoxicity
- Nephrotoxicity and ototoxicity (Correct answer)
- Photosensitivity
- QT prolongation
Correct answer: Nephrotoxicity and ototoxicity
Aminoglycosides accumulate in renal proximal tubule cells and cochlear hair cells, causing nephrotoxicity and ototoxicity.
Question 6: A patient experiences a severe anaphylactic reaction. What is the first-line treatment?
- IV diphenhydramine
- Oral prednisone
- Epinephrine IM 0.3–0.5 mg (Correct answer)
- Inhaled albuterol
Correct answer: Epinephrine IM 0.3–0.5 mg
Intramuscular epinephrine is the first-line treatment for anaphylaxis due to its rapid onset and alpha/beta adrenergic effects.
Question 7: Which drug class is contraindicated in patients with a history of hereditary angioedema?
- Beta-blockers
- Calcium channel blockers
- ACE inhibitors (Correct answer)
- Thiazide diuretics
Correct answer: ACE inhibitors
ACE inhibitors increase bradykinin levels, which can precipitate or worsen angioedema in susceptible patients.
Pharm.D. Doctor of Pharmacy Doctor of Pharmacy General 2
A patient on warfarin starts taking fluconazole.
What is the expected drug interaction?