Practice Test Geeks(PSA) Prescribing Safety Assessment Practice Test
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PSA Therapeutic Drug Monitoring Flashcards

6 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 PSA Therapeutic Drug Monitoring flashcards as text

  1. Which of the following drugs requires routine therapeutic drug monitoring (TDM) due to its narrow therapeutic index?

    Answer: Vancomycin

    Vancomycin has a narrow therapeutic index and requires routine TDM to ensure efficacy and prevent nephrotoxicity.

  2. A patient on digoxin has a serum level of 2.8 ng/mL. The therapeutic range is 0.5–2.0 ng/mL. What is the most appropriate next step?

    Answer: Hold digoxin and reassess

    A digoxin level above the therapeutic range indicates toxicity risk; the dose should be held and the patient reassessed for signs of toxicity.

  3. When should a trough level for vancomycin be drawn to accurately reflect steady-state concentrations?

    Answer: Immediately before the next dose

    Vancomycin trough levels should be drawn immediately before the next scheduled dose to reflect the lowest steady-state concentration.

  4. Which pharmacokinetic parameter is most important when interpreting TDM results for aminoglycosides?

    Answer: Peak and trough levels

    For aminoglycosides, both peak (efficacy) and trough (toxicity avoidance) levels are monitored to optimize dosing.

  5. A patient on phenytoin has a total level of 8 mcg/mL (therapeutic 10–20 mcg/mL) but appears clinically stable. Their albumin is 2.0 g/dL. What should you consider?

    Answer: Check free phenytoin level before adjusting

    Phenytoin is highly protein-bound; low albumin increases the free fraction, so a corrected or free phenytoin level is needed before adjusting the dose.

  6. Which of the following is the primary reason for performing TDM for lithium?

    Answer: Lithium toxicity can be life-threatening and its therapeutic window is narrow

    Lithium has a narrow therapeutic index and toxicity—manifesting as tremors, confusion, and cardiac arrhythmias—can be severe, making TDM essential.