Practice Test Geeks(PSA) Prescribing Safety Assessment Practice Test
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Prescribing in Special Populations Flashcards

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  1. A pregnant woman in her first trimester requires antibiotic therapy for a urinary tract infection. Which antibiotic is most appropriate?

    Answer: Cefalexin throughout pregnancy

    Cefalexin, a first-generation cephalosporin, is considered safe throughout pregnancy and is a first-line option for UTI treatment in pregnant women.

  2. A breastfeeding mother needs analgesia following a Caesarean section. Which analgesic should be used with the greatest caution?

    Answer: Codeine

    Codeine is converted to morphine by CYP2D6; in ultra-rapid metabolizers, excessive morphine passes into breast milk and can cause neonatal respiratory depression.

  3. Which antiepileptic drug carries the highest risk of neural tube defects when taken during the first trimester of pregnancy?

    Answer: Sodium valproate

    Sodium valproate is associated with the highest risk of neural tube defects (approximately 3-4%) and major congenital malformations among antiepileptic drugs.

  4. A woman with a mechanical heart valve is planning a pregnancy and is currently on warfarin. What is the most appropriate management for the first trimester?

    Answer: Switch to low molecular weight heparin during the first trimester

    Warfarin is teratogenic during the first trimester; low molecular weight heparin does not cross the placenta and is preferred during this period.

  5. Which class of antihypertensive drug is contraindicated throughout pregnancy?

    Answer: ACE inhibitors

    ACE inhibitors are contraindicated in pregnancy due to the risk of fetal renal dysgenesis, oligohydramnios, skull hypoplasia, and neonatal renal failure.

  6. A woman at 34 weeks gestation develops severe pre-eclampsia with a BP of 175/112 mmHg. What is the first-line drug treatment?

    Answer: IV labetalol

    IV labetalol is the first-line treatment for severe hypertension in pre-eclampsia as it is safe in pregnancy, rapid-acting, and well-evidenced.

  7. A breastfeeding mother is diagnosed with postnatal depression and requires an antidepressant. Which drug has the most safety data supporting use during breastfeeding?

    Answer: Sertraline

    Sertraline has the most published safety data in breastfeeding, with consistently low levels detected in breast milk and no adverse effects reported in exposed infants.