PSA Medication Safety 3

Question 1

Before initiating amiodarone therapy, which baseline investigations are most essential?

Accepted Answer

Thyroid function tests, liver function tests, and chest X-ray

Answer

Amiodarone is iodine-rich and can cause thyroid dysfunction, hepatotoxicity, and pulmonary toxicity, so TFTs, LFTs, and CXR are mandatory at baseline.

Question 2

A patient on lithium presents with coarse tremor, vomiting, diarrhea, and confusion. What is the most likely cause?

Accepted Answer

Lithium toxicity

Answer

Coarse tremor, GI upset, and neurotoxicity are hallmarks of lithium toxicity requiring urgent assessment and management.

Question 3

A patient on long-term methotrexate for rheumatoid arthritis requires regular monitoring. Which combination of tests is most important?

Accepted Answer

Full blood count and liver function tests at regular intervals

Answer

Methotrexate causes bone marrow suppression and hepatotoxicity, making regular FBC and LFTs essential for safe long-term use.

Question 4

A patient is being initiated on clozapine for treatment-resistant schizophrenia. Which monitoring is mandatory due to a life-threatening adverse effect?

Accepted Answer

Regular white blood cell count to detect agranulocytosis

Answer

Clozapine carries a mandatory WBC and neutrophil monitoring program because it can cause potentially fatal agranulocytosis in 1-2% of patients.

Question 5

A patient on ramipril for hypertension develops a persistent dry cough. What is the most appropriate next step?

Accepted Answer

Switch to an angiotensin receptor blocker such as losartan

Answer

ACE inhibitor-induced cough is a class effect caused by bradykinin accumulation; switching to an ARB eliminates the cough while maintaining antihypertensive efficacy.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA Medication Safety 3