Physician Assistant Pharmaceutical Therapeutics 3

Question 1

A 45-year-old with type 2 diabetes and established cardiovascular disease is started on an antidiabetic agent. Which class has demonstrated cardiovascular mortality benefit?

Accepted Answer

SGLT-2 inhibitors

Answer

SGLT-2 inhibitors (e.g., empagliflozin) have demonstrated significant reduction in major adverse cardiovascular events in large outcome trials.

Question 2

Which opioid analgesic has active metabolites that accumulate in renal failure and can cause CNS toxicity?

Accepted Answer

Morphine

Answer

Morphine-6-glucuronide accumulates in renal failure and can cause prolonged sedation, respiratory depression, and seizures.

Question 3

A patient with newly diagnosed seizure disorder is started on phenytoin. Which finding on CBC would be a serious adverse effect requiring dose adjustment?

Accepted Answer

Megaloblastic anemia

Answer

Phenytoin inhibits folate absorption, leading to megaloblastic anemia; folic acid supplementation may be necessary.

Question 4

Which beta-blocker is cardioselective and preferred in a patient with reactive airway disease requiring antihypertensive therapy?

Accepted Answer

Metoprolol succinate

Answer

Metoprolol succinate is a beta-1 selective blocker with minimal effect on beta-2 receptors in the bronchi at usual doses.

Question 5

A patient on clopidogrel for ACS is found to be a CYP2C19 poor metabolizer. What is the clinical implication?

Accepted Answer

Reduced antiplatelet effect and higher thrombotic risk

Answer

Clopidogrel requires CYP2C19 activation to its active metabolite; poor metabolizers have diminished platelet inhibition and higher risk of recurrent events.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Pharmaceutical Therapeutics 3