Module 12

Question 1

Which of the following best describes the pharmacokinetics of statin drug?
A. They are primarily distributed to adipocytes and muscle cells.
B. They are predominantly excreted unchanged in the urine.
C. They have a low hepatic extraction ratio.
D. They have a low oral bioavailability.

Answer 1

D. They have a low oral bioavailability.

Question 2

Which of the following patients would be at the highest risk of having a cardiovascular event?
A. Bill who has a Framingham score of 27.
B. Judy who has a Framingham score of 12.
C. Al who has a Framingham score of 7.
D. Theo who has a Framingham score of 17.

Answer 2

A. Bill who has a Framingham score of 27.

Question 3

Which of the following are adverse events a patient taking niacin might expect?
 A. Hypoglycemia.
 B. Muscle toxicity.
 C. Facial flushing.
 D. Constipation.

Answer 3

C. Facial flushing.

Question 4

Your patient has non-alcoholic fatty liver disease and has just been prescribed a statin to treat cholesterol. Which of the following tests would be most appropriate to perform before the patient starts taking the drug?
A. Measure blood levels of creatine kinase.
B. Measure blood levels of potassium.
C. Measure blood levels of ALT.
D. Measure blood levels of HDL cholesterol.

Answer 4

C. Measure blood levels of ALT.

Question 5

Your patient is being discharged from the hospital. Prior to admission they were taking the drug digoxin to treat heart failure. You notice that the bile acid sequestrant colsevelam has been added to the treatment regimen. You worry that:
A. Colsevelam inhibits a transporter so digoxin plasma levels will increase.
B. Colsevelam binds to digoxin in the intestine so digoxin levels will decrease.
C. Colsevelam causes diarrhea so digoxin absorption will be decreased.
D. Colsevelam and digoxin both cause hepatotoxicity so this patient will be at risk for combined toxicity.

Answer 5

B. Colsevelam binds to digoxin in the intestine so digoxin levels will decrease.

Question 6

What fraction of bile acids are normally reabsorbed from the intestine?
 A. 5%
 B. 25%
 C. 50%
 D. 95%

Answer 6

D. 95%

Question 7

Which of the following adverse events might a patient taking fibrates experience?
 A. Gall stones
 B. Facial flushing
 C. Constipation
 D. All are correct

Answer 7

A. Gall stones

Question 8

An Asian patient comes to the clinic with muscle soreness. You review the chart and see the patient is on 80 mg of rosuvastatin and 10 mg of ezetimibe. This is dangerous because:
A. A fatal interaction is known to occur between rosuvastatin and ezetimibe.
B. Ezetimibe is contraindicated in Asian patients.
C. Ezetimibe blocks the NPC1L1 transporter and therefore increases plasma rosuvastatin concentrations.
D. Asian patients have ~ two times higher plasma concentration of rosuvastatin than Caucasian patients. A high dose of rosuvastatin may cause rhabdomyolysis.

Answer 8

D. Asian patients have ~ two times higher plasma concentration of rosuvastatin than Caucasian patients. A high dose of rosuvastatin may cause rhabdomyolysis.

Question 9

Which of the following classes of drugs does not have its direct site of action in the liver?
 A. Statins
 B. Fibrates
 C. Bile acid sequestrants
 D. Niacin

Answer 9

C. Bile acid sequestrants

Question 10

What is the first line therapy lowering LDL cholesterol in patients?
 A. Lifestyle modification
 B. Statins
 C. Bile Acid Sequestrants
 D. Fibrates

Answer 10

A. Lifestyle modification