Taking levofloxacin concurrently with a calcium supplements can lead to subtherapeutic antibiotic blood levels. This is an example of an alteration in which pharmacokinetic category: 

A 38 y/o female is being treated by her dermatologist for plaque psoriasis. She is new to the clinic and your medical assistant completed her medication history. The following medications were recorded: tazarotene (Tazorac) 0.1 % cream daily methotrexate 7.5 mg daily triamcinolone 0.1 % ointment twice daily colloidal oatmeal bath (Aveeno soothing bath treatment) three times weekly. Which medication is transcribed incorrectly by the medical assistant and should be questioned by the nurse practitioner?

A patient presenting with mild intermittent asthma should be prescribed which of the following inhalers that can be used as an “as needed” reliever?

An oncology patient is scheduled to receive an intrathecal methotrexate injection (into the cerebrospinal fluid in the spinal cord). The nurse practitioner working with the radiology department is asked by the interventional radiologist when the last dose of enoxaparin (Lovenox) was. Why is the interventional radiologist concerned about the last dose of enoxaparin?

Which of the following are black box warnings for combination menopausal hormone replacement therapy?

The nurse practitioner evaluates a 55 y/o type 2 diabetic male in the office today. His last hemoglobin A1C was 8.1. His only current diabetic medication is metformin XR 1000 mg twice daily. He expresses interest in weight loss and a healthy diet. Which add-on option does the nurse practitioner consider to treat his diabetes and assist with weight loss with a mechanism of action of slowing gastric emptying?

What mechanism of action has the greatest risk for movement disorders?

A 62 y/o male with a history of cardiovascular disease and prior myocardial infarction is scheduled for an orthopedic procedure in 1 week. The orthopedic office staff mentioned to the patient that they usually need to hold all medications prior to surgery and that he should reach out to his primary care clinic office for directions (which he didn’t). He presents the night before surgery to the urgent care with symptoms of chest pain, diaphoresis, nausea, and dizziness. You review his medication list and are concerned about abrupt discontinuation of which of the following medications?

A patient with heart failure is prescribed furosemide twice daily to manage peripheral edema. Which lab is likely result of the furosemide therapy?

Which of the following should be avoided in a patient with heart failure?