Pharmaceutical Therapeutics Flashcards
7 cards from real Physician Assistant practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pharmaceutical Therapeutics flashcards as text
A patient with systolic heart failure (HFrEF) is on optimal medical therapy. Which medication has shown mortality reduction and is recommended by ACC/AHA guidelines as first-line?
Answer: Carvedilol (beta-blocker)
Beta-blockers including carvedilol, metoprolol succinate, and bisoprolol reduce mortality in stable HFrEF and are guideline-directed first-line therapy.
Which benzodiazepine is safest in elderly patients due to its lack of active metabolites and shorter half-life?
Answer: Lorazepam
Lorazepam undergoes direct glucuronidation with no active metabolites and is preferred in elderly patients per the Beers Criteria considerations.
A patient on rifampin for tuberculosis has a subtherapeutic oral contraceptive effect. What is the mechanism?
Answer: Induction of CYP3A4 increasing estrogen metabolism
Rifampin is a potent CYP3A4 inducer that accelerates estrogen and progestin metabolism, reducing plasma contraceptive concentrations.
Which second-generation antipsychotic is associated with the highest risk of metabolic syndrome, weight gain, and new-onset diabetes?
Answer: Clozapine/Olanzapine
Clozapine and olanzapine carry the highest metabolic risk among atypical antipsychotics; regular monitoring of weight, glucose, and lipids is mandatory.
A patient taking an MAO inhibitor for depression eats aged cheese and develops a hypertensive crisis. What is the mechanism?
Answer: Tyramine displaces norepinephrine from nerve terminals causing massive release
MAO normally metabolizes tyramine; when inhibited, dietary tyramine enters systemic circulation, displacing NE from storage vesicles causing a catecholamine surge.
Which antifungal requires monitoring of hepatic function and is associated with QT prolongation due to CYP3A4 inhibition?
Answer: Voriconazole
Voriconazole is a potent CYP inhibitor that prolongs QT interval and is hepatotoxic; LFTs and ECG monitoring are recommended during therapy.
A patient with Clostridium difficile infection (CDI) has a first recurrence after metronidazole treatment. What is the preferred management?
Answer: Fidaxomicin or vancomycin tapered/pulsed regimen
IDSA guidelines recommend fidaxomicin or a vancomycin tapered/pulsed regimen for first recurrence of CDI to reduce further recurrence rates.