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PHARMACIST QBANK & MOCK EXAM 3

Question 1:
JD is a 48-year-old female with a medical history significant for the following conditions: Type 2 Diabetes Mellitus (DM), Myocardial Infarction (MI) with stent placement and HFrEF less than 40%.

Medications	Laboratory Tests
Atorvastatin 80 mg PO daily	Total cholesterol: <200 mg/dL
Clopidogrel 75 daily/Aspirin 81 mg daily	LDL: less than 100 mg/dL
Sacubitril 49 mg/valsartan 51 mg PO BID	LFT: ALT: 7–56 U/L
Carvedilol 25 mg PO BID	FBG: 70–99 mg/dL
Spironolactone 25 mg PO daily	HbA1c <5.7%
Empagliflozin 10 mg daily,	Serum Creatinine: 0.5–1.1 mg/dL
Metformin 1 g daily

JD was diagnosed with peptic ulcer due to H. pylori infection and prescribed Clarithromycin 500 mg BID, Amoxicillin 1,000 mg BID, Metronidazole 500 mg BID, and Omeprazole 20 BID for 14 days. What is the most appropriate action for the pharmacist to take?
A. Dispense as prescribed and monitor closely.
B. Contact the provider to suggest a regimen without clarithromycin
C. Counsel the patient to stop using atorvastatin for 14 days.
D. Switch atorvastatin to pravastatin for the duration of therapy.
ANSWER

Answer: B. Contact the provider to suggest a regimen without clarithromycin

Helicobacter pylori Eradication Regimens Helicobacter pylori : Quadruple regimen
Clarithromycin 500 mg BID, Amoxicillin 1 g BID, Metronidazole 500 mg BID, PPI: Standard dose BID.

Duration: 10–14 days.

Advantages: Higher eradication rates compared to clarithromycin triple therapy.
Bismuth-based quadruple Therapy (Preferred in areas with high resistance):

Bismuth subsalicylate: 300 mg QID, Metronidazole: 500 mg TID or QID, Tetracycline: 500 mg QID, PPI: Standard dose BID

Duration: 10–14 days.

Advantages: Effective even in areas with high clarithromycin or metronidazole resistance.

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