PSA Medication Safety 2

Question 1

A patient stabilized on warfarin is prescribed ibuprofen for knee pain. What is the most significant safety concern?

Accepted Answer

Increased bleeding risk due to combined antiplatelet effects and GI irritation

Answer

NSAIDs like ibuprofen potentiate warfarin's anticoagulant effect and independently inhibit platelet aggregation, significantly increasing the risk of serious bleeding.

Question 2

Which drug combination carries the highest risk of causing serotonin syndrome?

Accepted Answer

Fluoxetine and tramadol

Answer

Tramadol inhibits serotonin reuptake and, when combined with an SSRI like fluoxetine, can cause life-threatening serotonin syndrome.

Question 3

An elderly patient on lisinopril is started on spironolactone for heart failure. Which electrolyte disturbance requires immediate monitoring?

Accepted Answer

Hyperkalemia

Answer

Both ACE inhibitors and potassium-sparing diuretics like spironolactone reduce potassium excretion, creating a high risk of dangerous hyperkalemia.

Question 4

Why should metformin be withheld before administration of iodinated contrast media?

Accepted Answer

Contrast-induced nephropathy can lead to metformin accumulation and lactic acidosis

Answer

If contrast causes acute kidney injury, metformin cannot be cleared and accumulates to levels that can cause life-threatening lactic acidosis.

Question 5

A patient on simvastatin 40 mg daily is prescribed clarithromycin for a respiratory infection. What is the primary concern?

Accepted Answer

Myopathy or rhabdomyolysis due to elevated simvastatin levels

Answer

Clarithromycin is a potent CYP3A4 inhibitor that dramatically increases simvastatin plasma levels, raising the risk of myopathy and rhabdomyolysis.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA Medication Safety 2