Urgent Care Urgent Care Medications and Prescribing 1 — Questions and Answers
Question 1: Which NSAID is preferred for pain management in a patient with a history of peptic ulcer disease?
- Ibuprofen 800 mg TID
- Naproxen 500 mg BID
- Celecoxib 200 mg daily (Correct answer)
- Aspirin 650 mg TID
Correct answer: Celecoxib 200 mg daily
Celecoxib, a selective COX-2 inhibitor, has a lower risk of GI ulceration compared to non-selective NSAIDs and is preferred in patients with peptic ulcer disease.
Question 2: What is the maximum recommended daily dose of acetaminophen for a healthy adult?
- 2,000 mg/day
- 3,000 mg/day
- 4,000 mg/day (Correct answer)
- 5,000 mg/day
Correct answer: 4,000 mg/day
The FDA recommends a maximum of 4,000 mg per day of acetaminophen in healthy adults, though 3,000 mg/day is recommended for chronic use.
Question 3: A patient with a penicillin allergy requires antibiotic treatment for cellulitis. Which antibiotic is most appropriate?
- Amoxicillin-clavulanate
- Cephalexin (with caution if mild allergy)
- Clindamycin (Correct answer)
- Trimethoprim-sulfamethoxazole
Correct answer: Clindamycin
Clindamycin is a safe alternative for skin and soft tissue infections (including cellulitis) in patients with penicillin allergy.
Question 4: Which opioid analgesic is considered most appropriate for short-term acute pain management in urgent care?
- Long-acting oxycodone (OxyContin)
- Short-acting hydrocodone-acetaminophen for ≤3–5 days (Correct answer)
- Methadone for moderate pain
- Extended-release morphine for musculoskeletal pain
Correct answer: Short-acting hydrocodone-acetaminophen for ≤3–5 days
Short-acting opioids prescribed for the shortest effective duration (≤3–5 days) are recommended for acute pain when non-opioid therapies are insufficient.
Question 5: Which drug interaction is most clinically significant when prescribing a fluoroquinolone antibiotic?
- Interaction with vitamin C supplements
- Increased QT prolongation risk with concurrent antiarrhythmics (Correct answer)
- Reduced efficacy when taken with food
- Interaction with acetaminophen causing hepatotoxicity
Correct answer: Increased QT prolongation risk with concurrent antiarrhythmics
Fluoroquinolones prolong the QT interval and, when combined with other QT-prolonging drugs such as antiarrhythmics, increase the risk of life-threatening arrhythmia.
Question 6: What is the appropriate prescribing recommendation for antibiotics in uncomplicated acute bronchitis in adults?
- Azithromycin 500 mg for 5 days
- Doxycycline 100 mg BID for 7 days
- No antibiotic — provide symptomatic treatment only (Correct answer)
- Amoxicillin 500 mg TID for 10 days
Correct answer: No antibiotic — provide symptomatic treatment only
Acute bronchitis is almost exclusively viral and does not benefit from antibiotic therapy; prescribing antibiotics increases resistance without clinical benefit.
Urgent Care Urgent Care Medications and Prescribing 1
Which NSAID is preferred for pain management in a patient with a history of peptic ulcer disease?