Ques. CV is a 68 year old female with hypertension, type 2 diabetes, and COPD. She has a documented allergy to sulfonamides (rash all over body). CV takes the following medications:

Bisoprolol 2.5 mg po daily

Perindopril 8 mg po daily

Rosuvastatin 20 mg po at bedtime

Metformin 850 mg po bid

Empagliflozin 10 mg po daily

Glycopyrronium 50 mcg by inhalation daily

Indacaterol 75 mcg by inhalation daily

CV was recently admitted to hospital for a NSTEMI and underwent coronary artery bypass graft (CABG) surgery three days ago. Which of the following antiplatelet regimens is optimal for CV following her CABG?

a. EC-ASA 325 mg po daily for one month post-CABG; then EC-ASA 80 mg po daily for one year post CABG

b. EC-ASA 325 mg po daily for one month post-CABG; then EC-ASA 80 mg po daily for life-long treatment

c. Clopidogrel 600 mg po once for one dose; then clopidogrel 75 mg po daily for life-long treatment

d. EC-ASA 80 mg po daily + clopidogrel 75 mg po daily for one year post-CABG; then EC-ASA 80 mg po daily alone for life-long treatment

 

Ques. LT is a 38 year old male who presents to his family health team with symptoms of influenza. The symptoms started 72 hours ago. His past medical history includes asthma and seasonal allergies. LT's medications include: Symbicort Turbuhaler (budesonide 200 mcg/formoterol 6 mcg) bid, salbutamol 100 mcg inhaled qid prn, and cetirizine 10 mg po daily prn. He reports that he is experiencing increasing shortness of breath and frequent use of salbutamol. A nasopharyngeal swab is sent for viral PCR. Which of the following anti-infectives is the most appropriate initial therapy for LT?

a. No anti-infective should be initiated as LT's symptoms have been present for more than 48 hours

b. Oral amantadine

c. Oral oseltamivir

d. Inhaled zanamivir

 

Ques. GT is a 59 year old female who has a stressful job that requires her to stand most of the day. She drinks two to three cups of coffee each day. Her medical history includes hypothyroidism, eczema on her face and legs, and muscle pain in her legs. Her current medications include:

Levothyroxine 100 mcg po daily

Betamethasone valerate 0.1% ointment bid to body

Tacrolimus 0.1% ointment once daily on face

Acetaminophen 500 mg po tid prn

GT reports to the pharmacist that she frequently doesn't sleep well due to the pain in her legs. She moves around in bed to find a comfortable position but can't find one. She has tried diphenhydramine 25 mg po at bedtime for several nights, but it has not helped and she is feeling exhausted most days. Which of the following is an appropriate initial recommendation from the pharmacist?

a. "Exercise moderately, stretch your legs, and take a warm bath before going to bed"

b. "Arrange to see your physician as soon as possible for an assessment of your thyroid function"

c. "Discontinue drinking coffee so that you can sleep better at night"

d. "Increase your dose of diphenhydramine to 50 mg at bedtime, as that is the effective dose"

 

Ques. Which of the following is a rare but serious risk associated with the use tofacitinib in rheumatoid arthritis patients?

a. Agranulocytosis

b. Stevens-Johnson syndrome

c. Torsades de pointes

d. Thrombosis