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66 Cards in this Set
- Front
- Back
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Which of the following statin regimens are considered high-intensity statin therapy? (Select ALL that apply.) Answer ACrestor 40 mg daily BLipitor 20 mg daily CCrestor 10 mg daily DLipitor 40 mg daily EZocor 40 mg daily |
ACrestor 40 mg daily
DLipitor 40 mg daily |
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Which of the following parameters are assessed on the Global Risk Assessment tool? (Select ALL that apply.) Answer AAge BLDL level CTotal cholesterol DHDL EGender |
AAge
CTotal cholesterol DHDL EGender |
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DL is a 61 y/o male being seen for routine follow up including his risk for ASCVD.
Current Medications: Inderal LA 80 mg daily Hydrochlorothiazide 25 mg daily Prinivil 10 mg daily Mylanta 20 mL Q6H Plavix 75 mg daily Aspirin 81 mg Nitroglycerin 0.3 mg PRN MVI daily
Past Medical History: Hypertension Dyslipidemia GERD s/p MI
Vitals: Height: 5'11" Weight: 202 lbs BP: 140/80 mmHg HR: 85 BPM RR: 20 BPM Temp: 98.6ºF Pain: 1/10
Labs: AST (units/L) = 32 (10 - 40) ALT (units/L) = 20 (10 - 40) CH, T (mg/dL) = 221 (125 - 200) TG (mg/dL) = 238 (< 150) HDL (mg/dL) = 32 (> 40) LDL (mg/dL) = GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 143 (135 - 145) K (mEq/L) = 4.1 (3.5 - 5) Cl (mEq/L) = 102 (95 - 103) HCO3 (mEq/L) = 26 (24 - 30) BUN (mg/dL) = 15 (7 - 20) SCr (mg/dL) = 0.8 (0.6 - 1.3) Mg (mEq/L) = 1.8 (1.3 - 2.1) PO4 (mg/dL) = 4.1 (2.3 - 4.7) Ca (mg/dL) = 9.7 (8.5 - 10.5) TSH (mIU/L) = 1.8 (0.3 - 3.0) Free T4 (mg/dL) = 0.7 (0.9 - 2.3)
DL was prescribed Crestor 40 mg, but his insurance will not cover a brand name statin, and no generic of Crestor is available. Which generic statin would be an appropriate alternative? Answer AAtorvastatin 20 mg BPravastatin 40 mg CAtorvastatin 40 mg DAtorvastatin 80 mg EPravastatin 80 mg |
DAtorvastatin 80 mg |
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Which of the following products are statin-niacin combinations? (Select ALL that apply.) Answer AAdvicor BSimcor CJuvisync DLiptruzet EVytorin |
AAdvicor BSimcor |
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Select the correct mechanism of action of Welchol: Answer AIt reduces cholesterol absorption at the brush-border. BIt is a peroxisome proliferator alpha activator. CIt increases HDL synthesis. DIt inhibits the enzyme HMG-CoA reductase. EIt binds to bile acids in the gut. |
EIt binds to bile acids in the gut. |
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Which of the following medications should be avoided with simvastatin? (Select ALL that apply.) Answer ALopid BVFEND CTheo-24 DPlavix EBiaxin
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ALopid BVFEND
EBiaxin |
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Which of the following patient types would benefit from moderate-intensity statin therapy according to the ACC/AHA ATP-4 guidelines? (Select ALL that apply.) Answer AThose unable to tolerate high-intensity statin therapy BA 35 year old with a LDL of 140 mg/dL and no other comorbidities CA 80 year old patient who is S/P MI DA 45 year old patient with diabetes and a LDL of 140 mg/dL and no other comorbidities; 10-year ASCVD risk score is 6.5% EA 32 year old with a LDL of 195 mg/dL and no other comorbidities |
AThose unable to tolerate high-intensity statin therapy
CA 80 year old patient who is S/P MI DA 45 year old patient with diabetes and a LDL of 140 mg/dL and no other comorbidities; 10-year ASCVD risk score is 6.5% |
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Which of the following formulations of niacin have less flushing and itching and relatively lower risk of hepatotoxicity? Answer ANiaspan BSlo-Niacin CNiacor DAdvicor ESimcor
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ANiaspan |
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In addition to an approval for lowering cholesterol when statins alone are not enough or when statins cannot be tolerated,Welchol has an additional indication for the following condition: Answer ATo reduce pain in rheumatoid arthritis. BTo help lower postprandial blood glucose in diabetes. CTo reduce uric acid in gout. DTo decrease cardiac remodeling in heart failure. ETo decrease symptoms associated with Crohn's disease or ulcerative colitis.
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BTo help lower postprandial blood glucose in diabetes. |
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A patient gave the pharmacist a prescription for Lipitor 40 mg PO daily. Which of the following is an appropriate generic substitution for Lipitor? Answer AAtorvastatin BLovastatin CPravastatin DSimvastatin ERosuvastatin |
AAtorvastatin |
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Possible side effects of Lovaza include: (Select ALL that apply.) Answer ABurping BArthralgias CDyspepsia DTaste perversions EFlatulence |
ABurping
CDyspepsia DTaste perversions |
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A patient gave the pharmacist a prescription for Livalo 2 mg PO daily. Which of the following is the generic name for Livalo? Answer AFluvastatin BLovastatin CPravastatin DPitavastatin ERosuvastatin |
DPitavastatin |
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A patient begins Niaspan and finds she suffers from red, itchy skin. She does not believe she can tolerate the medicine. Which of the following statements are correct that the pharmacist should provide to the patient? (Select ALL that apply.) Answer AIf your doctor permits it, take 325 mg of aspirin 30 minutes before the Niaspan; this should help reduce the problem. BTake Benadryl to reduce the problem since this is due to a histamine response. CAvoid alcohol, hot beverages and spicy food near the time of the medicine. DThis problem should lessen as you take the medicine continuously. ETake the Niaspan at bedtime; most of the problem will occur while you sleep. |
AIf your doctor permits it, take 325 mg of aspirin 30 minutes before the Niaspan; this should help reduce the problem.
CAvoid alcohol, hot beverages and spicy food near the time of the medicine. DThis problem should lessen as you take the medicine continuously. ETake the Niaspan at bedtime; most of the problem will occur while you sleep. |
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SJ is a 40 year old female being for evaluated for her dyslipidemia. She has an estimated ASCVD risk of 6.4%.
Current Medications: Hydrochlorothiazide 25 mg daily Ambien 5 mg QHS PRN Levothyroxine 112 mcg daily Prenatal MVI daily
Past Medical History: Dyslipidemia Hypertension Insomnia Hypothyroidism
Vitals: Height: 5'6" Weight: 160 lbs BP: 140/80 mmHg HR: 85 BPM RR: 20 BP Temp: 98.6ºF Pain: 1/10
AST (units/L) = 24 (10 - 40) ALT (units/L) = 21 (10 - 40) CH, T (mg/dL) = 242 (125-200) TG (mg/dL) = 189 (< 150) HDL (mg/dL) = 38 ( > 40) LDL (mg/dL) = 166 (< 100) GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 141 (135 - 145) K (mEq/L) = 4.2 (3.5 - 5) Cl (mEq/L) = 100 (95 - 103) HCO3 (mEq/L) = 28 (24 - 30) BUN (mg/dL) = 18 (7 - 20) SCr (mg/dL) = 0.9 (0.6 - 1.3) Mg (mEq/L) = 1.9 (1.3 - 2.1) PO4 (mg/dL) = 4.4 (2.3 - 4.7) Ca (mg/dL) = 9.5 (8.5 - 10.5) TSH (mIU/L) = 2.2 (0.3 - 3.0) hCG+
What statin therapy is most appropriate for her? Answer ASimvastatin 10 mg daily BLovastatin 20 mg daily CAtorvastatin 20 mg daily DRosuvastatin 20 mg daily EStatin therapy is not appropriate |
EStatin therapy is not appropriate |
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Which of the following side effects are associated with statin use? (Select ALL that apply.) Answer ARisk of diabetes BMemory loss CCough DMyopathy EGingival hyperplasia |
ARisk of diabetes BMemory loss
DMyopathy |
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A patient comes to the pharmacy with a prescription for Niaspan. Which is the best way to counsel the patient regarding administration? Answer ATake this medication in the morning, at breakfast. BTake this medication at dinner. CTake with medication on an empty stomach. DTake this medication at bedtime, after a low fat snack. ETake this medication after a low fat snack. |
DTake this medication at bedtime, after a low fat snack. |
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DL is a 61 y/o male being seen for routine follow up including his risk for ASCVD.
Current Medications: Inderal LA 80 mg daily Hydrochlorothiazide 25 mg daily Prinivil 10 mg daily Mylanta 20 mL Q6H Plavix 75 mg daily Aspirin 81 mg Nitroglycerin 0.3 mg PRN MVI daily
Past Medical History: Hypertension Dyslipidemia GERD s/p MI
Vitals: Height: 5'11" Weight: 202 lbs BP: 140/80 mmHg HR: 85 BPM RR: 20 BPM Temp: 98.6ºF Pain: 1/10
Labs: AST (units/L) = 32 (10 - 40) ALT (units/L) = 20 (10 - 40) CH, T (mg/dL) = 221 (125 - 200) TG (mg/dL) = 238 (< 150) HDL (mg/dL) = 32 (> 40) LDL (mg/dL) = GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 143 (135 - 145) K (mEq/L) = 4.1 (3.5 - 5) Cl (mEq/L) = 102 (95 - 103) HCO3 (mEq/L) = 26 (24 - 30) BUN (mg/dL) = 15 (7 - 20) SCr (mg/dL) = 0.8 (0.6 - 1.3) Mg (mEq/L) = 1.8 (1.3 - 2.1) PO4 (mg/dL) = 4.1 (2.3 - 4.7) Ca (mg/dL) = 9.7 (8.5 - 10.5) TSH (mIU/L) = 1.8 (0.3 - 3.0) Free T4 (mg/dL) = 0.7 (0.9 - 2.3)
According to the ACC/AHA Treatment of Blood Cholesterol Guideline, what would be the most appropriate statin regimen for DL? Answer APravastatin 40 mg daily BRosuvastatin 20 mg daily CLovastatin 40 mg daily DAtorvastatin 20 mg daily EPitavastatin 4 mg daily |
BRosuvastatin 20 mg daily |
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A patient is going to start niacin therapy. Which of the following are side effects of niacin? (Select ALL that apply.) Answer ARenal impairment BIncrease in blood sugar CIncrease in blood pressure DIncrease in uric acid EFlushing |
BIncrease in blood sugar
DIncrease in uric acid EFlushing |
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Which of the following statements are correct concerning bile acid sequestrants? (Select ALL that apply.) Answer ASipping or holding the cholestyramine suspension in the mouth can lead to tooth decay. BThese agents can lower TGs significantly. CThese agents can cause diarrhea. DThe patient should be told to take a multivitamin at a separate time due to a possible risk of decreased A, D, E and K absorption. EColesevelam is only available as tablets. |
ASipping or holding the cholestyramine suspension in the mouth can lead to tooth decay.
DThe patient should be told to take a multivitamin at a separate time due to a possible risk of decreased A, D, E and K absorption. |
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Nancy, a 64 year old female, has diabetes, heart failure and hyperlipidemia. She has been using atorvastatin 40 mg daily for the past four months. She is adherent with therapy. Her LDL was taken today and reported to be 124 mg/dL. Nancy's physician determines her LDL goal should be <100 mg/dL. Her physician wishes to double the atorvastatin dose; he states this will help Nancy reach her LDL goal. Choose the correct statement. Answer ADoubling the atorvastatin dose will likely lower the LDL to below 100 mg/dL. BThe patient may be able to reach the correct LDL goal if she switches to pitavastatin. CHer LDL goal should be less than 130 mg/dL; therefore, she is at goal. DAtorvastatin is contraindicated in patients with heart failure. EAccording to the ACC/AHA ATP-4 guidelines, treating to specific LDL targets is no longer recommended.
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EAccording to the ACC/AHA ATP-4 guidelines, treating to specific LDL targets is no longer recommended. |
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What effects do statins have on cholesterol values? (Select ALL that apply.) Answer ARaises HDL BLowers HDL CRaises triglycerides DLowers LDL ELowers triglycerides |
ARaises HDL
DLowers LDL ELowers triglycerides |
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A 42 year old patient returns to clinic to initiate statin therapy. He has diabetes, hypertension, HIV, and an ASCVD risk of 8.6%. His calculated LDL is 159 mg/dL. He is on Glucophage, Zestril, Vascepa, Prezista, Norvir, and Truvada. Patient is a non-smoker but has an alcoholic drink twice a month. Which statin regimen should be recommended? Answer AAtorvastatin 80 mg BRosuvastatin 10 mg CAtorvastatin 20 mg DAtorvastatin 40 mg ERosuvastatin 20 mg |
ERosuvastatin 20 mg |
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HL, a 42 year old male, has gained 40 pounds over the last 5 years since he injured his left knee and can no longer play basketball. He has a sedentary lifestyle including a job that requires him to be at a desk all day. HL has tried the Atkins diet, South Beach diet, and many other popular diets but has gained the weight back. HL does not smoke and admits to having 1-3 alcoholic beverages per month. Lifestyle modifications have been inadequate in controlling his weight gain.
Current Medications: Vasotec 10 mg daily Norvasc 10 mg daily Glucophage 850 mg BID Claritin 10 mg daily Tylenol 500 mg Q4-6H PRN MVI daily
Past Medical History: Allergic rhinitis Dyslipidemia Diabetes mellitus Hypertension
Vitals: Height: 5'11" Weight: 225 lbs BP: 140/80 mmHg HR: 85 BPM RR: 20 BPM Temp: 98.6ºF Pain: 1/10
4/14/14 Labs: AST (units/L) = 37 (10 - 40) ALT (units/L) = 32 (10 - 40) CH, T (mg/dL) = 247 (125 - 200) TG (mg/dL) = 242 (< 150) HDL (mg/dL) = 34 (> 40) LDL (mg/dL) = 183 ( < 100) GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 143 (135 - 145) K (mEq/L) = 4.1 (3.5 - 5) Cl (mEq/L) = 102 (95 - 103) HCO3 (mEq/L) = 26 (24 - 30) BUN (mg/dL) = 15 (7 - 20) SCr (mg/dL) = 0.8 (0.6 - 1.3) Mg (mEq/L) = 1.8 (1.3 - 2.1) PO4 (mg/dL) = 4.1 (2.3 - 4.7) Ca (mg/dL) = 9.7 (8.5 - 10.5) TSH (mIU/L) = 2.2 (0.3 - 3.0) Hgb A1B = 7.9% (4 - 6%)
10/9/14 Labs: AST (units/L) = 168 (10 - 40) ALT (units/L) = 145 (10 - 40) CH, T (mg/dL) = 224 (125 - 200) TG (mg/dL) = 218 (< 150) HDL (mg/dL) = 35 (> 40) LDL (mg/dL) = 145 ( < 100) GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 142 (135 - 145) K (mEq/L) = 4.2 (3.5 - 5) Cl (mEq/L) = 97 (95 - 103) HCO3 (mEq/L) = 29 (24 - 30) BUN (mg/dL) = 18 (7 - 20) SCr (mg/dL) = 0.9 (0.6 - 1.3) Mg (mEq/L) = 1.9 (1.3 - 2.1) PO4 (mg/dL) = 4.3 (2.3 - 4.7) Ca (mg/dL) = 9.5 (8.5 - 10.5) TSH (mIU/L) = 1.8 (0.3 - 3.0) Hgb A1C = 7.7% (4 - 6%)
HL has an estimated 10-year ASCVD risk of 6.9%. According to the ACC/AHA Treatment of Blood Cholesterol Guideline, what would be the most appropriate statin regimen for HL? Answer ASimvastatin 10 mg daily BSimvastatin 40 mg daily CAtorvastatin 40 mg daily DPravastatin 20 mg daily EPravastatin 40 mg daily
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EPravastatin 40 mg daily |
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Maria has been given a prescription for simvastatin 20 mg PO QHS. Which of the following statements are correct? (SelectALL that apply.) Answer AMary can take this medication in the morning if it works better for her schedule. BSimvastatin can cause pancreatitis; triglycerides should be monitored. CThe brand name of simvastatin is Zocor. DThe dose of simvastatin can be titrated to a max dose of 40 mg/day. EShe needs to take her simvastatin with food. |
CThe brand name of simvastatin is Zocor. DThe dose of simvastatin can be titrated to a max dose of 40 mg/day. |
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A patient with a history of gout is going to start niacin therapy. Which of the following statements are correct? Answer ANiacin is contraindicated in gout, even if controlled with a uric acid lowering agent. BNiacin does not have an effect on uric acid. CNiacin will decrease the risk of the patient developing gout. DNiacin blocks xanthine oxidase. ENiacin should be used with caution if a patient has gout.
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ENiacin should be used with caution if a patient has gout. |
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What other names is niacin known by? (Select ALL that apply.) Answer AB1 BB2 CB3 DBiotin ENicotinic Acid
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CB3
ENicotinic Acid |
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Maurice is a 58 year-old male with dyslipidemia and prostate enlargement. He was started on and is currently taking pravastatin 40 mg daily and tamsulosin 0.4 mg daily. Today he reports with muscle aches. The physician discontinued the pravastatin and evaluated Maurice for other conditions that can increase muscle damage and found none. According to the ACC/AHA ATP-4 guidelines, what would be an appropriate next step for treating Maurice's dyslipidemia? Answer AIf muscle aches resolve, restart pravastatin at 20 mg daily. BIf muscle aches do not resolve, restart pravastatin at 20 mg daily. CIf muscle aches resolve, start rosuvastatin at 20 mg daily. DIf muscle aches do not resolve, start rosuvastatin at 20 mg daily. EIf muscle aches resolve, do not use statin therapy again. |
AIf muscle aches resolve, restart pravastatin at 20 mg daily. |
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A patient gave the pharmacist a prescription for Pravachol 40 mg PO daily. Which of the following is an appropriate generic substitution for Pravachol? Answer AAtorvastatin BLovastatin CPravastatin DPitavastatin ERosuvastatin |
CPravastatin |
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How often should the Global Risk Assessment tool be done if a patient is classified as low risk? Answer AYearly BSemi-annually CEvery 3 years DEvery 4-6 years EEvery 10 years |
DEvery 4-6 years |
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Which counseling point is true for niacin? Answer ASeparate niacin and multivitamins by at least 2 hours BAvoid dairy-containing products CTake niacin 4-6 hours after bile acid sequestrants DTake with hot beverages ETake with spicy food |
CTake niacin 4-6 hours after bile acid sequestrants |
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How should Welchol tablets be administered? Answer AOn an empty stomach BWith a meal and liquid CAt bedtime DWith liquids only EWithout regards to meals |
BWith a meal and liquid |
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Which of the following statements regarding Lovaza are true? (Select ALL that apply.) Answer ALovaza can be tried as an alternative to fenofibrates for lowering TGs. BLovaza must be used in addition to a low-fat diet. CIf the patient uses OTC fish oils, they may need to double the amount of capsules to get similar TG lowering. DLovaza does not increase LDL levels. EThe max dose of Lovaza is 2 capsules per day. |
ALovaza can be tried as an alternative to fenofibrates for lowering TGs. BLovaza must be used in addition to a low-fat diet. CIf the patient uses OTC fish oils, they may need to double the amount of capsules to get similar TG lowering. |
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What effects can gemfibrozil have on lipids? (Select ALL that apply.) Answer ADecreases TG BIncreases HDL CDecreases LDL DIncreases LDL EDecreases HD |
ADecreases TG BIncreases HDL CDecreases LDL DIncreases LDL |
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A pharmacist instructs a patient to contact the doctor right away if he is passing brown or dark-colored urine, feeling more tired than usual or if his skin and/or whites of the eyes become yellow. Which of the following drugs is the most likely to need this counseling? Answer AQuestran BZetia CAdvicor DLovaza EMetamucil |
CAdvicor |
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What precentage on the 10-year ASCVD risk assessment score is used as the cut point to start statin therapy? Answer A≥ 2.5% B≥ 5% C≥ 7.5% D≥ 10% E≥ 15% |
C≥ 7.5% |
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What is the indication for Lovaza? Answer ATo lower LDL cholesterol in patients with an LDL cholesterol ≥ 200 mg/dL. BTo lower triglycerides in patients with TGs ≥ 500 mg/dL as an adjunct to diet. CTo increase HDL in patients with familial-induced low HDL levels. DTo reduce the risk of statin-induced muscle damage. ETo lower triglycerides in patients with TGs ≥ 400 mg/dL as an adjunct to diet. |
BTo lower triglycerides in patients with TGs ≥ 500 mg/dL as an adjunct to diet. |
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A patient brings a prescription for Niacor to the pharmacy, but it is not in stock. However, Niaspan is in stock and Slo-Niacin is available over the counter. What do you recommend? Answer ADispense Niaspan only BDispense Slo-Niacin only CDispense Niaspan or Slo-Niacin DDispense Niaspan and Slo-Niacin and recommend concurrent use EDo not dispense |
EDo not dispense |
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Which fibrate has an indication for use with a statin? Answer ATrilipix BTricor CLofibra DLipofen EFibricor
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ATrilipix |
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Select the correct mechanisms of action of the statins. (Select ALL that apply.) Answer AStatins inhibit the enzyme HMG-CoA reductase. BStatins block the rate-limiting step in cholesterol synthesis. CStatins reduce cholesterol absorption at the brush-border. DStatins are peroxisome proliferator alpha activators. EStatins bind to and inhibit microsomal triglyceride transfer protein (MTP) in the endoplasmic reticulum. |
AStatins inhibit the enzyme HMG-CoA reductase. BStatins block the rate-limiting step in cholesterol synthesis. |
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A patient gave the pharmacist a prescription for Crestor 10 mg PO daily. Which of the following is an appropriate generic substitution for Crestor? Answer AAtorvastatin BLovastatin CPravastatin DSimvastatin ERosuvastatin |
ERosuvastatin |
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A patient with chronic angina is currently taking aspirin, diltiazem, metoprolol and ranolazine. The physician wants to start the patient on simvastatin. Which of the following statements is correct regarding simvastatin in this patient? Answer AThe maximum dose of simvastatin is 10 mg daily due to the drug interaction with ranolazine. BThe maximum dose of simvastatin is 40 mg daily due to the drug interaction with ranolazine. CThe maximum dose of simvastatin is 10 mg daily due to the drug interaction with diltiazem. DThe maximum dose of simvastatin is 20 mg daily due to the drug interaction with diltiazem. ESimvastatin is contraindicated in patients with chronic angina. |
CThe maximum dose of simvastatin is 10 mg daily due to the drug interaction with diltiazem |
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Which groups would find benefit from statin therapy according to the ACC/AHA ATP-4 guidelines? (Select ALL that apply.) Answer APatients who have a coronary stent placed 4 years ago BPatients who have a LDL value > 160 mg/dL CA 45 year old patient with diabetes and a LDL of 95 mg/dL DA 25 year old patient with diabetes and a LDL of 101 mg/dL EA 55 year old patient with an estimated 10 year ASCVD risk of 6% |
APatients who have a coronary stent placed 4 years ago
CA 45 year old patient with diabetes and a LDL of 95 mg/dL |
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HL, a 42 year old male, has gained 40 pounds over the last 5 years since he injured his left knee and can no longer play basketball. He has a sedentary lifestyle including a job that requires him to be at a desk all day. HL has tried the Atkins diet, South Beach diet, and many other popular diets but has gained the weight back. HL does not smoke and admits to having 1-3 alcoholic beverages per month. Lifestyle modifications have been inadequate in controlling his weight gain.
Current Medications: Vasotec 10 mg daily Norvasc 10 mg daily Glucophage 850 mg BID Claritin 10 mg daily Tylenol 500 mg Q4-6H PRN MVI daily
Past Medical History: Allergic rhinitis Dyslipidemia Diabetes mellitus Hypertension
Vitals: Height: 5'11" Weight: 225 lbs BP: 140/80 mmHg HR: 85 BPM RR: 20 BPM Temp: 98.6ºF Pain: 1/10
4/14/14 Labs: AST (units/L) = 37 (10 - 40) ALT (units/L) = 32 (10 - 40) CH, T (mg/dL) = 247 (125 - 200) TG (mg/dL) = 242 (< 150) HDL (mg/dL) = 34 (> 40) LDL (mg/dL) = 183 ( < 100) GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 143 (135 - 145) K (mEq/L) = 4.1 (3.5 - 5) Cl (mEq/L) = 102 (95 - 103) HCO3 (mEq/L) = 26 (24 - 30) BUN (mg/dL) = 15 (7 - 20) SCr (mg/dL) = 0.8 (0.6 - 1.3) Mg (mEq/L) = 1.8 (1.3 - 2.1) PO4 (mg/dL) = 4.1 (2.3 - 4.7) Ca (mg/dL) = 9.7 (8.5 - 10.5) TSH (mIU/L) = 2.2 (0.3 - 3.0) Hgb A1B = 7.9% (4 - 6%)
10/9/14 Labs: AST (units/L) = 168 (10 - 40) ALT (units/L) = 145 (10 - 40) CH, T (mg/dL) = 224 (125 - 200) TG (mg/dL) = 218 (< 150) HDL (mg/dL) = 35 (> 40) LDL (mg/dL) = 145 ( < 100) GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 142 (135 - 145) K (mEq/L) = 4.2 (3.5 - 5) Cl (mEq/L) = 97 (95 - 103) HCO3 (mEq/L) = 29 (24 - 30) BUN (mg/dL) = 18 (7 - 20) SCr (mg/dL) = 0.9 (0.6 - 1.3) Mg (mEq/L) = 1.9 (1.3 - 2.1) PO4 (mg/dL) = 4.3 (2.3 - 4.7) Ca (mg/dL) = 9.5 (8.5 - 10.5) TSH (mIU/L) = 1.8 (0.3 - 3.0) Hgb A1C = 7.8% (4 - 6%)
What intervention would be most appropriate on visit 10/9/14? Answer AIncrease statin dose BDecrease statin dose CDiscontinue statin therapy DAdd a bile acid sequestrant EAdd niacin
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CDiscontinue statin therapy |
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A prescriber ordered TriCor 145 mg daily for his patient. The pharmacy did not have this exact strength, but did have Lofibra134 mg. Can the pharmacist substitute Lofibra for the Tricor? Answer ANo, they are not interchangeable. BYes, if the pharmacist does not have anything better. CYes, because the doses are similar. DYes, because Lofibra 134 mg is bioequivalent to TriCor 145 mg. EYes, because he checked the Red Book. |
ANo, they are not interchangeable. |
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A patient with atrial fibrillation is currently taking aspirin, metoprolol, digoxin and verapamil. The physician wants to start the patient on lovastatin. Which of the following statements is correct regarding lovastatin in this patient? Answer AThe maximum dose of lovastatin is 20 mg daily due to the drug interaction with verapamil. BThe maximum dose of lovastatin is 40 mg daily due to the drug interaction with verapamil. CThe maximum dose of lovastatin is 20 mg daily due to the drug interaction with digoxin. DThe maximum dose of lovastatin is 40 mg daily due to the drug interaction with digoxin. ELovastatin is contraindicated in patients with atrial fibrillation.
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AThe maximum dose of lovastatin is 20 mg daily due to the drug interaction with verapamil. |
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What statements are true about lomitapide? (Select ALL that apply.) Answer AIt is pregnancy category X BIt has a boxed warning for renal toxicity CIt is indicated for homozygous familial hypercholesterolemia DIt has a boxed warning for hepatotoxicity EEnrollment in REMS program is not required |
AIt is pregnancy category X
CIt is indicated for homozygous familial hypercholesterolemia DIt has a boxed warning for hepatotoxicity
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Which formulation of niacin has the highest risk for liver damage? Answer ANiaspan BSlo-Niacin CNiacor DInositol hexanicotinate EInositol hexaniacinate
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BSlo-Niacin |
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What condition is a contraindication to using mipomersen (Kynamro)? Answer ARenal disease or moderate to severe renal impairment BHepatic disease or moderate to severe hepatic impairment CPregnancy DConcurrent use with strong CYP3A4 inhibitors EArterial hemorrhage |
BHepatic disease or moderate to severe hepatic impairment |
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Which of the following cholesterol-lowering agents can increase bleeding risk and should be used cautiously in at-risk patients? Answer AQuestran BVascepa CLipitor DTricor ETrilipix |
BVascepa |
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What are the individual medicines included in the combination drug Vytorin? Answer AAtorvastatin + Niacin BAtorvastatin + Ezetimibe CLovastatin + Niacin DSimvastatin + Ezetimibe ESimvastatin + Niacin |
DSimvastatin + Ezetimibe |
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Which of the following patient types would benefit from high-intensity statin therapy according to the ACC/AHA ATP-4 guidelines? (Select ALL that apply.) Answer AA 60 year old patient who is S/P MI BA 35 year old with a LDL of 140 mg/dL and no other comorbidies CA 80 year old patient who is S/P MI DA 45 year old patient with diabetes and a LDL of 140 mg/dL and no other comorbidities; 10-year ASCVD risk score is 6.5% EA 32 year old with a LDL of 195 mg/dL and no other comorbidites |
AA 60 year old patient who is S/P MI
EA 32 year old with a LDL of 195 mg/dL and no other comorbidites |
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A patient gave the pharmacist a prescription for Mevacor 40 mg PO nightly with dinner. Which of the following is an appropriate generic substitution for Mevacor? Answer AAtorvastatin BLovastatin CPravastatin DSimvastatin ERosuvastatin
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CPravastatin |
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Which of the following cholesterol-lowering drug classes require liver enzyme monitoring at baseline due to a risk of hepatotoxicity? (Select ALL that apply.) Answer AFish oils BNiacins CFenofibrates DStatins EBile acid sequestrants |
BNiacins CFenofibrates DStatins |
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A patient's triglycerides were recorded at 282 mg/dL. In which of the following conditions are the fenofibrate agents contraindicated? (Select ALL that apply.) Answer AHeart failure BGout CGallbladder disease DPregnancy ESevere liver disease |
CGallbladder disease
ESevere liver disease |
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Maurice is a 58 year-old male with dyslipidemia and prostate enlargement. His only medication is tamsulosin 0.4 mg daily. He states that he cannot tolerate pravastatin due to muscle aches and joint pain. His cholesterol panel has the following values: Total CH 188 mg/dL, HDL 36 mg/dL, and TG 338 mg/dL. Calculate the patient's LDL cholesterol: Answer A64 mg/dL B84 mg/dL C104 mg/dL D114 mg/dL E125 mg/dL |
B84 mg/dL |
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Which fibrate is given twice daily? Answer ATrilipix BTricor CLofibra DAntara ELopid |
ELopid |
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Jerry is a 70 year-old patient who was started on immediate-release niacin therapy. He is taking his medicine with food, and using an aspirin prior to the evening dose, but still gets hot, flushed and itchy. He asks if there is any form of niacin which would cause less flushing and itching. Which of the following niacin formulations have less flushing and itching? (Select ALLthat apply.) Answer ARed yeast rice BSlo-Niacin CNiacor DNicotine ENiaspan |
BSlo-Niacin
ENiaspan |
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A patient's triglycerides were recorded at 510 mg/dL. Which of the following agents will help to lower triglycerides? (SelectALL that apply.) Answer ALovaza BTrilipix CNiacin DVascepa EWelChol |
ALovaza BTrilipix CNiacin DVascepa |
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Which statins can be taken any time of the day? (Select ALL that apply.) Answer ACrestor BSimvastatin CLovastatin DLipitor ELivalo |
ACrestor
DLipitor ELivalo |
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Lovaza should be dispensed with caution to a patient with this allergy: Answer AFish or shellfish BDairy CSulfa DSoy or peanuts EFenofibrate medications
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AFish or shellfish |
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Which of the following drugs could raise lipoprotein levels? (Select ALL that apply.) Answer AMontelukast BCyclosporine CAmiodarone DPrednisone EBeta-blockers |
BCyclosporine CAmiodarone DPrednisone EBeta-blockers |
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Which three statins undergo first pass metabolism by which CYP enzyme? Answer ASimvastatin, lovastatin, rosuvastatin; CYP3A4 BSimvastatin, fluvastatin, atorvastatin; CYP2D6 CSimvastatin, lovastatin, pravastatin; CYP2C19 DSimvastatin, lovastatin, atorvastatin; CYP3A4 ESimvastatin, lovastatin, atorvastatin; CYP2D6
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DSimvastatin, lovastatin, atorvastatin; CYP3A4 |
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Which of the following statins should be taken with the evening meal? Answer AAtorvastatin BLovastatin immediate-release CPravastatin DSimvastatin ELovastatin extended-release |
BLovastatin immediate-release |
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DL is a 61 y/o male being seen for routine follow up including his risk for ASCVD.
Current Medications: Inderal LA 80 mg daily Hydrochlorothiazide 25 mg daily Prinivil 10 mg daily Mylanta 20 mL Q6H Plavix 75 mg daily Aspirin 81 mg Nitroglycerin 0.3 mg PRN MVI daily
Past Medical History: Hypertension Dyslipidemia GERD s/p MI
Vitals: Height: 5'11" Weight: 202 lbs BP: 140/80 mmHg HR: 85 BPM RR: 20 BPM Temp: 98.6ºF Pain: 1/10
Labs: AST (units/L) = 32 (10 - 40) ALT (units/L) = 20 (10 - 40) CH, T (mg/dL) = 221 (125 - 200) TG (mg/dL) = 238 (< 150) HDL (mg/dL) = 32 (> 40) LDL (mg/dL) = GLU (mg/dL) = 108 (65 - 99) Na (mEq/L) = 143 (135 - 145) K (mEq/L) = 4.1 (3.5 - 5) Cl (mEq/L) = 102 (95 - 103) HCO3 (mEq/L) = 26 (24 - 30) BUN (mg/dL) = 15 (7 - 20) SCr (mg/dL) = 0.8 (0.6 - 1.3) Mg (mEq/L) = 1.8 (1.3 - 2.1) PO4 (mg/dL) = 4.1 (2.3 - 4.7) Ca (mg/dL) = 9.7 (8.5 - 10.5) TSH (mIU/L) = 1.8 (0.3 - 3.0) Free T4 (mg/dL) = 0.7 (0.9 - 2.3)
What is DL’s calculated LDL? Answer A129 mg/dL B141 mg/dL C149 mg/dL D161 mg/dL E173 mg/dL
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B141 mg/dL |
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A patient was prescribed atorvastatin 20 mg daily and returns to the clinic after having blood tests performed. His transaminases are elevated two times above the upper limit of normal (ULN). His primary care physician asks at what level should his statin therapy be discontinued due to elevated hepatic transaminase levels? Answer A2 times ULN; discontinue therapy now B3 times ULN C4 times ULN D5 times ULN E10 times ULN |
B3 times ULN |
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Adjunct to diet, Myalept is indicated to treat: Answer AHypertriglyceridemia without congenital or acquired generalized lipodystrophy BLeptin deficiency with congenital or acquired generalized lipodystrophy CLeptin deficiency without congenital or acquired generalized lipodystrophy DHIV-related dystrophy EMetabolic disease |
BLeptin deficiency with congenital or acquired generalized lipodystrophy |
