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 is a potent CYP2C9 inhibitor that reduces warfarin metabolism, raising INR and bleeding risk.

Question 2

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

Accepted Answer

Approximately 4-5 half-lives

Answer

Steady state is reached after approximately 4-5 half-lives regardless of dose or dosing interval.

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

Vancomycin is renally eliminated, so impaired renal function requires extending the dosing interval to prevent toxicity.

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

Unnecessary drug therapy — taking a medication without a valid clinical indication — is a recognized category of medication-related problems in MTM.

Question 5

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

Accepted Answer

Hypokalemia

Answer

Loop diuretics inhibit the Na-K-2Cl transporter, increasing urinary potassium loss and causing hypokalemia.

Pharmacy Practice Test