Pharmacy Clinical Pharmacy 2

Question 1

A patient on warfarin is started on fluconazole. What is the expected pharmacokinetic interaction?

Accepted Answer

Fluconazole inhibits CYP2C9, increasing warfarin levels and bleeding risk

Answer

Fluconazole induces CYP2C9, decreasing warfarin levels

Answer

Fluconazole induces CYP3A4, increasing warfarin metabolism

Answer

No clinically significant interaction exists

Question 2

Which parameter best describes the time required to reach steady-state plasma concentration?

Accepted Answer

Approximately 4-5 half-lives

Answer

Volume of distribution

Answer

Bioavailability

Answer

Clearance

Question 3

A patient with a serum creatinine of 2.4 mg/dL requires vancomycin dosing. What adjustment is necessary?

Accepted Answer

Reduce dose frequency due to decreased renal clearance

Answer

No adjustment needed; vancomycin is hepatically cleared

Answer

Increase the loading dose to compensate for altered distribution

Answer

Switch to an oral formulation

Question 4

A pharmacist reviews a medication therapy management (MTM) encounter. Which of the following is a medication-related problem?

Accepted Answer

Unnecessary drug therapy with no medical indication

Answer

Patient preference for brand-name drugs

Answer

Requesting a 90-day supply for convenience

Answer

Using a pill organizer

Question 5

Which electrolyte imbalance is most commonly associated with loop diuretic use?

Accepted Answer

Hypokalemia

Answer

Hyperkalemia

Answer

Hypernatremia

Answer

Hypercalcemia

Question 6

A patient taking lithium presents with nausea, tremor, and a serum lithium level of 1.9 mEq/L. What is the appropriate action?

Accepted Answer

Hold lithium and consider dialysis if symptoms worsen

Answer

Continue current dose and recheck in one week

Answer

Increase the dose to achieve better therapeutic effect

Answer

Add a mood stabilizer and continue lithium unchanged

Question 7

Which statement best describes pharmacodynamic tolerance?

Accepted Answer

Decreased receptor sensitivity with repeated drug exposure

Answer

Increased renal clearance of a drug over time

Answer

Faster first-pass metabolism after chronic dosing

Answer

Induction of drug-metabolizing enzymes by the drug itself