Physician Assistant Pharmaceutical Therapeutics 4

Question 1

A child with otitis media has a penicillin allergy documented as hives. Which antibiotic is most appropriate?

Accepted Answer

Cefdinir

Answer

Cross-reactivity between penicillins and cephalosporins is low (<2%); cefdinir is acceptable for non-anaphylactic penicillin allergy in otitis media.

Question 2

Which drug used for HIV is a protease inhibitor known to cause hyperlipidemia, lipodystrophy, and hyperglycemia as metabolic side effects?

Accepted Answer

Ritonavir

Answer

Ritonavir and other protease inhibitors are associated with significant metabolic complications including dyslipidemia, fat redistribution, and insulin resistance.

Question 3

A patient on SSRIs is started on tramadol. Which serious drug interaction could result?

Accepted Answer

Serotonin syndrome

Answer

Tramadol inhibits serotonin reuptake; combined with SSRIs this can precipitate serotonin syndrome presenting with hyperthermia, agitation, and clonus.

Question 4

A patient with gout and hyperuricemia is started on allopurinol. When should urate-lowering therapy ideally begin relative to an acute gout flare?

Accepted Answer

Only after the acute flare has resolved, typically 2-4 weeks later

Answer

Initiating urate-lowering therapy during an acute flare can prolong or worsen symptoms; it is generally started 2-4 weeks after resolution.

Question 5

Which pharmacological mechanism accounts for the anticoagulant action of direct oral anticoagulants (DOACs) such as apixaban?

Accepted Answer

Direct inhibition of factor Xa

Answer

Apixaban and rivaroxaban are direct factor Xa inhibitors that prevent conversion of prothrombin to thrombin without requiring a cofactor like antithrombin.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Pharmaceutical Therapeutics 4