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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. Prednisone 10 mg orally daily is prescribed for a 68-year-old 60-kg patient with acute temporal arteritis. The pharmacotherapy specialist would recommend which of the following?

A) Dose should be decreased to 5 mg daily.
B) Prednisone should be discontinued after 2 Weeks.
C) Dose should be increased to 60 mg daily.
D) Dose should be increased to 20 mg daily.

2. A 70-year-old 45-kg patient is admitted to the ICU with a diagnosis of digoxin intoxication. The patient complains of nausea, blurred vision, and fatigue that have been present for 3 days. A cardiac monitor reveals a HR of 42 bpm, an irregular rhythm, and a type second-degree heart block. Current medications include digoxin 0.25 mg and furosemide 40mg for heart failure, both taken daily at 0800. The patient remains adherent to all medications despite nausea, including today's doses. Blood is drawn at 1200 with the following results:
* Potassium: 6.0 mEq/L
* Creatinine: 2.3 mg/dL
* Digoxin: 1.7 ng/mL
Which of the following most appropriately describes the patient's digoxin concentration?

A) A pre-distribution digoxin concentration, which may be misinterpreted
B) Reflects the effect of furosemide on the renal excretion of digoxin
C) A concentration within the desirable range
D) A post-distribution digoxin concentration, which indicates significant toxicity

3. A 65-year-old woman on chronic hemodialysis presents with difficulty breathing and inability to sleep. The patient has had shortness of breath, diaphoresis, and nausea, but has not vomited.
She denies having abdominal pain, diarrhea, or chest pain. She has tachycardia and tachypnea, and exhibits peaked T waves with occasional PVCs on the ECG. Serum chemistry values are:
* Sodium: 137 mEq/L
* BUN: 125 mg/dL
* Potassium: 7.2 mEq/L
* Creatinine: 12.8 mg/dL
* Chloride: 97 mEq/L
* Glucose: 95 mg/dL
* HCO3- : 11 mEq/L
* Calcium: 8.5 mg/dL
* Albumin: 3.1 g/dL
* Phosphorus: 1.7 mg/dL
Which of the following should the pharmacotherapy specialist recommend for immediate therapy?

A) Sodium polystyrene sulfonate with sorbitol orally
B) Sodium bicarbonate intravenously
C) Hemodialysis
D) Calcium gluconate intravenously

4. A pharmacotherapy specialist in a managed-care organization is about to review a new drug for the treatment of osteoporosis. The P&T committee will use the results in deciding whether to add the new drug to the formulary. Which of the following information would be most helpful?

A) The new drug will cost $15600 more than the current formulary drug to prevent one fracture.
B) With the new drug, the number of patients needed to treat for the prevention of one fracture is 25.
C) The annual cost of the new drug for the organization's population of patients with osteoporosis would be $2.7 million
D) The new drug is associated with a 32% reduction in the fracture rate.

5. A 78-year-old woman presents to the outpatient clinic for workup for depression. Medical history includes hypertension, simple partial seizures, and osteoporosis. The patient reports a
6.8 kg non-intentional weight loss over the past month. Home medications include lisinopril, hydrochlorothiazide, carbamazepine, and alendronate. The patient has been diagnosed with severe depression. Which antidepressant should be recommended for this patient?

A) Escitalopram 20 mg daily
B) Nortriptyline 25 mg daily
C) Mirtazapine 15 mg daily
D) Bupropion XL 150 mg daily

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