Pharmacy Therapeutics 5

Question 1

A patient with gout has a serum uric acid of 9.2 mg/dL and frequent flares. What is the target serum uric acid level with urate-lowering therapy?

Accepted Answer

<6 mg/dL

Answer

The ACR recommends a serum uric acid target of <6 mg/dL to prevent urate crystal deposition and reduce gout flare frequency.

Question 2

Which antifungal agent works by inhibiting ergosterol synthesis through binding to lanosterol 14α-demethylase?

Accepted Answer

Fluconazole

Answer

Azoles like fluconazole inhibit fungal CYP51 (lanosterol 14α-demethylase), blocking ergosterol synthesis and disrupting the fungal cell membrane.

Question 3

A patient receiving vancomycin develops flushing, erythema, and pruritis over the neck and upper torso during infusion. What is this reaction called and how is it managed?

Accepted Answer

Red man syndrome — slow the infusion rate

Answer

Red man syndrome is a rate-dependent infusion reaction caused by histamine release; slowing the infusion rate and premedication with antihistamines prevent recurrence.

Question 4

Which inhaler technique error is most common with dry powder inhalers (DPIs) compared to metered-dose inhalers (MDIs)?

Accepted Answer

Inhaling too slowly

Answer

DPIs require a fast, forceful inhalation to disaggregate and deliver the powder, so inhaling too slowly results in inadequate drug deposition in the lungs.

Question 5

A patient on methotrexate for rheumatoid arthritis is prescribed trimethoprim-sulfamethoxazole for a UTI. What is the primary concern?

Accepted Answer

Additive myelosuppression and folate depletion

Answer

Both methotrexate and TMP-SMX inhibit dihydrofolate reductase and folate utilization, leading to additive myelosuppression and risk of severe bone marrow toxicity.

Pharmacy Practice Test

Pharmacy Practice Test

Pharmacy Therapeutics 5