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1.2.4: Develop and implement individualized treatment plans, taking into consideration pharmacologic classes and characteristics of drugs

Which glaucoma medication class should be avoided in patients with a sulfa allergy?

(A) Prostaglandin analogs

(B) Beta-blockers

(C) Calcium channel blockers

(D) Carbonic anhydrase inhibitors

The correct answer is (D).

Carbonic anhydrase inhibitors (D) contain a sulfa moiety, and should be avoided in patients with a sulfa allergy.

Prostaglandin analogs (A), beta-blockers (B), and calcium channel blockers (C) can be administered to patients with sulfa allergies.

Which of the following antineoplastic agents is a vesicant?

(A) 5-Fluorouracil

(B) Fulvestrant

(C) Doxorubicin

(D) Methotrexate

The Correct Answer is: C

Extravasation of doxorubicin (C) does cause tissue necrosis. The administration of doxorubicin and other anthracycline antitumor antibiotics should only be performed by trained personnel.

Extravasation of 5-fluorouracil (A) does not cause tissue necrosis. Fulvestrant (B) is not a vesicant. It is administered as an IM injection. Extravasation of methotrexate (D) does not cause tissue necrosis.

Topic: Breast cancer

OU is a 63-year-old woman with HF (NYHA class I) receiving furosemide 20 mg twice daily, lisinopril 10 mg daily, metoprolol succinate 50 mg daily, digoxin 0.125 mg daily, and spironolactone 25 mg daily. During her routine clinic visit today, pertinent findings include: BP 125/77 mm Hg, HR 70 bpm, RR 13 rpm, K + 5.1 mmol/L, BUN 32 mg/dL, creatinine 1.1 mg/dL (baseline), and serum digoxin concentration of 0.8 ng/mL. Which of the following is the most appropriate change to optimize OU's medical regimen?

(A) Increase ACE inhibitor dose

(B) Increase beta-blocker dose

(C) Increase digoxin dose

(D) Increase spironolactone dose

The Correct Answer is: B

For heart failure management, beta-blocker therapy should be titrated to target doses demonstrated in clinical trials, to improve major outcomes such as morbidity and mortality. This patient has adequate blood pressure to increase therapy. In addition, the heart rate is adequate to further titrate her beta-blocker dose. Up-titration of beta-blocker therapy (B) is the safest medication change for this patient.

For heart failure management, ACE inhibitor therapy (A) should be titrated to target doses demonstrated in clinical trials to improve outcomes such as morbidity and mortality. This patient has adequate blood pressure to increase therapy. Unfortunately, ACE inhibitors are associated with dose-related ...

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