Physician Assistant Pharmaceutical Therapeutics 5

Question 1

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?

Accepted Answer

Carvedilol (beta-blocker)

Answer

Beta-blockers including carvedilol, metoprolol succinate, and bisoprolol reduce mortality in stable HFrEF and are guideline-directed first-line therapy.

Question 2

Which benzodiazepine is safest in elderly patients due to its lack of active metabolites and shorter half-life?

Accepted Answer

Lorazepam

Answer

Lorazepam undergoes direct glucuronidation with no active metabolites and is preferred in elderly patients per the Beers Criteria considerations.

Question 3

A patient on rifampin for tuberculosis has a subtherapeutic oral contraceptive effect. What is the mechanism?

Accepted Answer

Induction of CYP3A4 increasing estrogen metabolism

Answer

Rifampin is a potent CYP3A4 inducer that accelerates estrogen and progestin metabolism, reducing plasma contraceptive concentrations.

Question 4

Which second-generation antipsychotic is associated with the highest risk of metabolic syndrome, weight gain, and new-onset diabetes?

Accepted Answer

Clozapine/Olanzapine

Answer

Clozapine and olanzapine carry the highest metabolic risk among atypical antipsychotics; regular monitoring of weight, glucose, and lipids is mandatory.

Question 5

A patient taking an MAO inhibitor for depression eats aged cheese and develops a hypertensive crisis. What is the mechanism?

Accepted Answer

Tyramine displaces norepinephrine from nerve terminals causing massive release

Answer

MAO normally metabolizes tyramine; when inhibited, dietary tyramine enters systemic circulation, displacing NE from storage vesicles causing a catecholamine surge.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Pharmaceutical Therapeutics 5