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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. A 46-year-old patient begins treatment with allopurinol 300 mg daily following the onset of an acute gout attack due to elevated uric acid.
The patient's other medications are:
* Cyclosporine 800 mg daily
* Prednisone 20 mg daily
* Azathioprine 100 mg daily
* Nifedipine extended release 90 mg daily
Several days later there was an observed decrease in the patient's WBC count. Which drug interaction with allopurinol is most likely to account for this change?

A) Prednisone
B) Azathioprine
C) Cyclosporine
D) Nifedipine

2. A patient asks for advice relative to an herbal supplement to treat heart failure. The patient is currently NYHA Class III (LVEF 25%) and is adherent to medications, which include digoxin
0.25 mg daily, furosemide 40 mg daily, lisinopril 10 mg daily, carvedilol 6.25 mg twice daily, potassium 20 mEq daily, and simvastatin 40 mg nightly.
The patient has BP of 120/78 mm Hg, HR of 60 bpm, 9 cm JVD, 2+ pitting edema, and has experienced a 2.3 kg weight gain in last 2 days. All laboratory values are within normal limits.
Based on the following information, what is the most appropriate suggestion for the patient?

A) Omega-3-fatty acid
B) L-Carnitine
C) Coenzyme Q10
D) Avoidance of dietary supplements

3. A prospective randomized study is being developed to evaluate the effects of steroids on mortality in patients who are admitted for head injury Patients will be randomly assigned to receive 48 hours of methylprednisolone or placebo. The study will have an 80% power to detect a 2% difference in mortality. Which of the following is an appropriate null hypothesis for this study?

A) Methylprednisolone will have a 20% reduction in mortality compared with placebo.
B) Methylprednisolone and placebo are not different with respect to effect on mortality.
C) Methylprednisolone reduces mortality in head injury patients.
D) Methylprednisolone will increase mortality by 2% compared with placebo.

4. After 9 days of hospitalization, a 60-year-old 60-kg patient has a temperature of 39.4°C and a WBC count of 20,000 cells/uL. A sputum sample shows numerous WBCs and Gram-negative bacilli. The serum creatinine is 1.0 mg/dL. For this patient, which of the following drugs would be most appropriate for initial parenteral therapy?

A) Ceftriaxone and azithromycin
B) Aztreonam, clindamycin, and vancomycin
C) Cefepime, levofloxacin, and vancomycin
D) Tobramycin and cefepime

5. A pharmacotherapy specialist is conducting a pharmacokinetic study of a drug. The pharmacokinetic profile of this drug is best described by a one-compartment model with a mean elimination rate constant of 0.173/h. The standard curve for the assay to be used covers the range of 5-40mcg/mL. Samples are collected shortly after single intravenous bolus drug administration, and at 4 and 8 hours after dosing. Preliminary analysis shows that the 4-hour sample concentration is 25 mcg/mL. In this situation, which of the following statements is correct?

A) All plasma concentrations are probably within the range of the standard curve and can be reliably measured.
B) The initial plasma concentration is probably outside the range of the standard curve' it may be possible to dilute the sample and re-assay.
C) Both the initial and 8-hour concentration points are probably outside the range of the standard curve but can be reliably quantitated by extrapolating the curve to higher and lower points.
D) Both the initial and 8-hour concentration points are probably outside the range of the standard curve and cannot be reliably measured without diluting the samples.

Solutions: