Question 1

A PATIENT STARTS A NEW ANTIHYPERTENSIVE. TWO WEEKS LATER SHE REPORTS A PERSISTENT DRY COUGH WITH NO OTHER SYMPTOMS. WHICH DRUG CLASS, IDENTIFIABLE BY ITS -PRIL SUFFIX, IS MOST LIKELY RESPONSIBLE?

Accepted Answer

AN ACE INHIBITOR (SUCH AS LISINOPRIL). ACE inhibitors (the -pril class) block the breakdown of bradykinin, and the resulting buildup irritates the airway, producing the class's hallmark dry cough -- a reaction the other three classes don't cause.

Question 2

A DIABETIC PATIENT ON A BETA BLOCKER (-OLOL) IS WARNED THE DRUG CAN MASK THE WARNING SIGNS OF ___.

Accepted Answer

HYPOGLYCEMIA. Beta blockers blunt the adrenergic warning signs -- tachycardia and tremor -- that normally alert a diabetic patient to hypoglycemia, though sweating usually still occurs.

Question 3

A PATIENT ON A LIPID-LOWERING DRUG ENDING IN -STATIN CALLS THE CLINIC REPORTING DIFFUSE MUSCLE ACHING AND UNUSUALLY DARK URINE. WHAT COMPLICATION SHOULD THE NURSE SUSPECT FIRST?

Accepted Answer

RHABDOMYOLYSIS. Muscle pain with dark, myoglobin-laden urine is the classic presentation of statin-induced rhabdomyolysis, a rare but serious adverse effect that requires stopping the drug and checking creatine kinase.

Question 4

A PATIENT TAKING A FLUOROQUINOLONE (-OXACIN) FOR A UTI REPORTS SUDDEN HEEL PAIN AND DIFFICULTY BEARING WEIGHT DAYS AFTER STARTING THE DRUG. WHAT SHOULD THE NURSE SUSPECT?

Accepted Answer

ACHILLES TENDINOPATHY OR RUPTURE. Fluoroquinolones carry a boxed warning for tendinopathy and tendon rupture, most often the Achilles tendon, with the risk highest in older adults and those also taking corticosteroids.

Question 5

A MIGRAINE PATIENT IS PRESCRIBED A -TRIPTAN. BEFORE DISPENSING, THE PHARMACIST CHECKS FOR WHICH PRE-EXISTING CONDITION BECAUSE IT IS A CONTRAINDICATION?

Accepted Answer

CORONARY ARTERY DISEASE. Triptans cause cranial and coronary vasoconstriction through 5-HT1 receptor agonism, so they are contraindicated in patients with coronary artery disease or uncontrolled hypertension because of the risk of coronary vasospasm.

Question 6

THE SUFFIX -AZOLE IS NOT ALWAYS AN ANTIFUNGAL CLUE. WHICH OF THESE DRUGS IS ACTUALLY A BENZODIAZEPINE, NOT AN AZOLE ANTIFUNGAL?

Accepted Answer

ALPRAZOLAM. Alprazolam ends in -azolam, part of the benzodiazepine family, while fluconazole, ketoconazole and itraconazole are all azole antifungals -- a reminder that suffix recognition needs the full ending, not just a substring.

Question 7

A PATIENT ON LONG-TERM OMEPRAZOLE (A -PRAZOLE DRUG) FOR GERD IS FOUND TO HAVE A HIP FRACTURE AFTER A MINOR FALL. WHAT LONG-TERM RISK OF PROTON PUMP INHIBITORS DOES THIS ILLUSTRATE?

Accepted Answer

REDUCED CALCIUM ABSORPTION AND INCREASED FRACTURE RISK. Chronic acid suppression from PPIs is associated with reduced calcium absorption and an FDA-flagged increased risk of hip, wrist and spine fractures with long-term, high-dose use.

Question 8

A PATIENT GIVEN A -CILLIN ANTIBIOTIC FOR A SKIN INFECTION DEVELOPS HIVES AND THROAT SWELLING WITHIN MINUTES -- THE NURSE SUSPECTS ___.

Accepted Answer

ANAPHYLAXIS. Penicillins are a leading cause of drug-induced anaphylaxis, an IgE-mediated hypersensitivity reaction that can progress to airway compromise within minutes and requires immediate epinephrine.

Question 9

A PATIENT ON AN IV HEPARIN DRIP FOR FIVE DAYS DEVELOPS A PLATELET COUNT THAT HAS DROPPED BY MORE THAN HALF FROM BASELINE, ALONGSIDE A NEW LEG CLOT. WHAT DOES THE NURSE SUSPECT?

Accepted Answer

HEPARIN-INDUCED THROMBOCYTOPENIA (HIT). HIT is an immune-mediated reaction in which antibodies against heparin-platelet factor 4 complexes paradoxically cause both a sharp platelet drop and new clot formation, and it requires stopping heparin immediately.

Question 10

FAMOTIDINE, A -TIDINE DRUG, REDUCES STOMACH ACID BY BLOCKING ___ RECEPTORS ON GASTRIC PARIETAL CELLS.

Accepted Answer

HISTAMINE. H2-receptor antagonists like famotidine block histamine's action on parietal cells, reducing the acid secretion that histamine would otherwise stimulate.

Question 11

A MAN STARTING DOXAZOSIN, A -ZOSIN DRUG, FOR BPH IS WARNED ABOUT FAINTING WITH THE FIRST DOSE DUE TO ORTHOSTATIC ___.

Accepted Answer

HYPOTENSION. Alpha-1 blockers cause pronounced vasodilation, and the first dose can trigger a sharp drop in standing blood pressure, so the first dose is typically given at bedtime.

Question 12

AN OLDER ADULT IS PRESCRIBED BOTH A BENZODIAZEPINE (-ZOLAM OR -ZEPAM) AND AN OPIOID FOR PAIN. WHAT IS THE PRIORITY SAFETY CONCERN?

Accepted Answer

ADDITIVE RESPIRATORY DEPRESSION. Benzodiazepines and opioids both depress the central nervous system, and combining them significantly increases the risk of profound sedation and fatal respiratory depression -- the reason for the FDA's boxed warning on this combination.

Question 13

A PREGNANT PATIENT IS PRESCRIBED A -CYCLINE ANTIBIOTIC FOR A RESPIRATORY INFECTION. WHY WOULD THE PRESCRIBER TYPICALLY AVOID THIS CLASS IN PREGNANCY?

Accepted Answer

IT CAN PERMANENTLY DISCOLOR DEVELOPING TEETH AND AFFECT BONE GROWTH. Tetracyclines bind to calcium in developing teeth and bone, causing permanent tooth discoloration and inhibited bone growth in the fetus or young child, so they are avoided in pregnancy and in children under 8.

Question 14

A PATIENT WITH TYPE 2 DIABETES STARTS AN SGLT2 INHIBITOR (-GLIFLOZIN) AND TWO WEEKS LATER REPORTS RECURRENT GENITAL ITCHING AND DISCOMFORT. WHAT IS THE MOST LIKELY CAUSE?

Accepted Answer

INCREASED URINARY GLUCOSE PROMOTING A GENITAL YEAST INFECTION. SGLT2 inhibitors block glucose reabsorption in the kidney, so more glucose is excreted in the urine -- that glucose-rich environment predisposes patients to genital mycotic infections, a well-documented class effect.

Drug Classifications and Suffixes