Pharm.D. Doctor of Pharmacy Doctor of Pharmacy General 3 — Questions and Answers
Question 1: What is the therapeutic drug monitoring target trough for vancomycin AUC/MIC in serious MRSA infections?
- 100–200 mg·h/L
- 400–600 mg·h/L (Correct answer)
- 800–1200 mg·h/L
- 200–400 mg·h/L
Correct answer: 400–600 mg·h/L
Current ASHP/IDSA guidelines recommend a vancomycin AUC/MIC target of 400–600 mg·h/L for serious MRSA infections.
Question 2: A pregnant patient in her first trimester needs an antibiotic. Which is generally considered safest?
- Tetracycline
- Fluoroquinolones
- Amoxicillin (Correct answer)
- Trimethoprim
Correct answer: Amoxicillin
Penicillins like amoxicillin are FDA Pregnancy Category B and considered safe throughout pregnancy.
Question 3: What is the primary mechanism by which statins reduce cardiovascular risk?
- Increasing HDL synthesis
- Inhibiting HMG-CoA reductase to reduce cholesterol synthesis (Correct answer)
- Activating lipoprotein lipase
- Blocking bile acid reabsorption
Correct answer: Inhibiting HMG-CoA reductase to reduce cholesterol synthesis
Statins inhibit HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis, reducing LDL levels.
Question 4: Which opioid is preferred for patients with renal failure due to lack of active metabolite accumulation?
- Morphine
- Hydromorphone
- Fentanyl (Correct answer)
- Codeine
Correct answer: Fentanyl
Fentanyl is metabolized to inactive metabolites and is preferred in renal failure to avoid accumulation of toxic active metabolites.
Question 5: A pharmacist identifies a medication error before dispensing. What is the MOST appropriate first action?
- Dispense the medication as prescribed
- Document the error and dispense correctly
- Contact the prescriber to clarify and correct the order (Correct answer)
- Report to the state board immediately
Correct answer: Contact the prescriber to clarify and correct the order
Contacting the prescriber to clarify and correct the order is the appropriate first step in resolving a prescription error.
Question 6: Which antiepileptic drug requires monitoring of serum sodium due to risk of hyponatremia?
- Phenytoin
- Valproic acid
- Oxcarbazepine (Correct answer)
- Levetiracetam
Correct answer: Oxcarbazepine
Oxcarbazepine causes SIADH-like syndrome leading to hyponatremia, requiring periodic sodium monitoring.
Question 7: What is the role of P-glycoprotein (P-gp) in drug disposition?
- It activates prodrugs in the liver
- It is an efflux transporter that limits drug absorption and CNS penetration (Correct answer)
- It conjugates drugs with glucuronic acid
- It mediates drug-receptor binding affinity
Correct answer: It is an efflux transporter that limits drug absorption and CNS penetration
P-gp is an ATP-dependent efflux pump that transports drugs out of cells, limiting intestinal absorption and CNS entry.
