PSI Clinical Therapeutics

Question 1

What is the mechanism of action of proton pump inhibitors (PPIs) such as omeprazole?

Accepted Answer

They irreversibly inhibit the hydrogen-potassium ATPase enzyme (proton pump) in gastric parietal cells, reducing gastric acid secretion

Answer

PPIs work by irreversibly binding to the H+/K+-ATPase enzyme system (the proton pump) on the surface of gastric parietal cells. This blocks the final step of acid production, providing potent and long-lasting suppression of gastric acid secretion.

Question 2

A patient is prescribed warfarin. Which of the following interactions should the pharmacist be most concerned about?

Accepted Answer

Concurrent use of NSAIDs such as ibuprofen, which increases the risk of bleeding

Answer

NSAIDs increase bleeding risk with warfarin through multiple mechanisms: they inhibit platelet function, can cause GI erosion, and some (like fluconazole) inhibit CYP2C9, which metabolises warfarin. Pharmacists should counsel patients about avoiding OTC NSAIDs and reporting any signs of bleeding.

Question 3

What is the first-line treatment for mild-to-moderate community-acquired pneumonia in adults in Ireland?

Accepted Answer

Amoxicillin

Answer

According to Irish antibiotic prescribing guidelines, amoxicillin is the first-line treatment for community-acquired pneumonia in adults. For penicillin-allergic patients, doxycycline or clarithromycin are alternatives. This follows antimicrobial stewardship principles.

Question 4

What counselling points should a pharmacist provide to a patient starting a statin (e.g., atorvastatin)?

Accepted Answer

Take at the recommended time, report unexplained muscle pain, have liver function monitored, avoid grapefruit juice in large quantities, and understand it is for long-term use

Answer

Key counselling points include: take consistently (some statins are best taken at night), report muscle pain/weakness (risk of rhabdomyolysis), baseline and follow-up liver function tests, avoid excessive grapefruit juice (CYP3A4 interaction with some statins), and emphasise long-term adherence.

Question 5

What is the difference between a generic medicine and a branded medicine?

Accepted Answer

A generic contains the same active ingredient, dose, and dosage form as the brand but is marketed under the non-proprietary (generic) name, usually at a lower cost

Answer

Generic medicines must contain the same active ingredient in the same dose and dosage form as the reference (branded) product and must demonstrate bioequivalence. They are approved by the HPRA and meet the same quality standards but are typically less expensive as they do not carry development costs.

PSI Pharmacy Practice Test

PSI Pharmacy Practice Test

PSI Clinical Therapeutics