Pharmacology (2026) Q&A
1. You are seeing a 7-year-old who has been diagnosed with a seizure disorder and is
being managed with carbamazepine (Tegretol) suspension. Which statement
accurately describes the correct information about administration of this drug?
A) The suspension is thick, so shake it well before using
B) Discontinue immediately if a rash develops and administer Benadryl
C) Add the suspension to a grape-flavored liquid antihistamine
D) The suspension is thick, so dilute it with orange juice
Correct Answer: A) The suspension is thick, so shake it well before using
Rationale: Carbamazepine suspension is thick and requires vigorous shaking before
each dose to ensure uniform drug distribution. A rash requires medical evaluation,
not Benadryl, and the suspension should not be mixed with other liquids without
provider guidance.
2. A patient on lamotrigine (Lamictal) for bipolar disorder develops a rash within the
first three weeks of therapy. What is the most appropriate action?
A) Reassure the patient that this is a common benign side effect
B) Discontinue the drug immediately and evaluate for Stevens-Johnson syndrome
C) Prescribe an antihistamine and continue the lamotrigine
D) Reduce the dose and monitor the rash progression
Correct Answer: B) Discontinue the drug immediately and evaluate for Stevens-
Johnson syndrome
,Rationale: Lamotrigine carries a black box warning for serious skin rashes, including
Stevens-Johnson syndrome, especially within the first 2-8 weeks of therapy. Any rash
requires immediate drug discontinuation and medical evaluation. Antihistamines or
dose reduction are not appropriate.
3. Phenytoin (Dilantin) exhibits nonlinear pharmacokinetics. What does this mean for
dosing?
A) Small dose changes can cause large changes in serum levels
B) The drug is completely eliminated within 24 hours
C) It has a very short half-life
D) It does not reach steady state
Correct Answer: A) Small dose changes can cause large changes in serum levels
Rationale: Phenytoin follows saturation (zero-order) kinetics at therapeutic levels,
meaning small dose increases can cause disproportionate rises in serum
concentration, increasing toxicity risk. This requires careful dose titration and
monitoring.
4. A patient on valproic acid (Depakote) for a seizure disorder is planning to become
pregnant. What is the most important counseling point?
A) Valproic acid is safe during pregnancy
B) Valproic acid has a high risk of neural tube defects; alternative therapy should be
considered
C) The dose should be doubled during pregnancy
D) There are no pregnancy concerns with valproic acid
Correct Answer: B) Valproic acid has a high risk of neural tube defects; alternative
therapy should be considered
, Rationale: Valproic acid is a known teratogen with a high risk of neural tube defects
and other congenital anomalies. Women of childbearing potential should be
counseled on these risks and alternative therapies should be considered.
5. Which of the following medication classes has the strongest evidence for migraine
prophylaxis?
A) Beta-blockers (propranolol)
B) ACE inhibitors (lisinopril)
C) Calcium channel blockers (verapamil)
D) Angiotensin receptor blockers (losartan)
Correct Answer: A) Beta-blockers (propranolol)
Rationale: Beta-blockers, particularly propranolol and metoprolol, have strong
evidence for migraine prophylaxis and are considered first-line preventive
treatments. They reduce migraine frequency by blocking beta-adrenergic receptors
and stabilizing neuronal membranes.
6. A 28-year-old female with a history of migraines asks about non-pharmacologic
options for prevention. Which supplement has the strongest evidence for migraine
prevention?
A) Vitamin D
B) Feverfew
C) Omega-3 fatty acids
D) Magnesium
Correct Answer: B) Feverfew