Therapeutic Applications and Clinical Use Flashcards

A patient with chronic heart failure is prescribed digoxin. Which serum electrolyte must be closely monitored to prevent digoxin toxicity?

Answer: Potassium

Hypokalemia potentiates digoxin toxicity by increasing drug binding to Na+/K+-ATPase.

Metformin is contraindicated in a patient with an eGFR below 30 mL/min/1.73m² primarily because of the risk of:

Answer: Lactic acidosis

Reduced renal clearance causes metformin accumulation, leading to lactic acidosis risk.

Which of the following is the first-line pharmacological treatment for uncomplicated hypertension in a Black, non-diabetic patient according to JNC guidelines?

Answer: Thiazide diuretic or calcium channel blocker

Thiazide diuretics and CCBs are preferred first-line agents in Black patients due to greater efficacy.

A patient taking warfarin starts a course of fluconazole. What clinical adjustment is most likely needed?

Answer: Decrease warfarin dose

Fluconazole inhibits CYP2C9, reducing warfarin metabolism and increasing anticoagulant effect.

Sublingual nitroglycerin is used in acute angina attacks primarily because this route:

Answer: Avoids first-pass metabolism

The sublingual route delivers nitroglycerin directly into systemic circulation, bypassing hepatic first-pass metabolism.

Which drug class is used as first-line therapy for acute gout flares due to its anti-inflammatory mechanism targeting neutrophil function?

Answer: Colchicine

Colchicine inhibits microtubule polymerization, impairing neutrophil migration and phagocytosis in gouty joints.

A patient with GERD unresponsive to antacids is started on omeprazole. Its mechanism involves irreversible inhibition of:

Answer: H+/K+-ATPase proton pump

Omeprazole, a PPI, covalently inhibits the H+/K+-ATPase enzyme on parietal cells, suppressing acid secretion.