PEBC Exam Questions with Verified Answers Latest Update 2025 Already Passed
Which CYP-interacting drugs increase the levels of propranolol and metoprolol? - Answers CYP2D6
inhibitors (e.g. amiodarone, paroxetine)
How does digoxin benefit CHF? Atrial fibrillation? - Answers Digoxin is a mild positive ionotrope to help
HF and is a negative chronotrope to help Afib.
Which beta-blocker is more likely to cause CNS side effects, such as depression and insomnia? Why -
Answers Propranolol will have more CNS side effects due to its greater lipid solubility and ability to cross
the BBB.
Name 4 cardioselective beta-blockers. What are the implications of this selectivity? - Answers Atenolol
Acebutolol
Bisoprolol
Metoprolol
Higher selectivity means less non-cardiac side effects, such as bronchospasm.
Which 2 beta blockers have intrasympathetic activity or ISA? What are the implications of this? -
Answers Pindolol
Acebutolol
This may be preferred beta blocker agents in patients that are already bradycardic at rest as they have
less effect on the heart rate.
The 3 DHP-CCBs. - Answers Amlodipine
Felodipine
Nifedipine
Characteristics side effects of DHP-CCBs. - Answers Ankle edema
Flushing
The 2 non-DHP-CCBs - Answers Diltiazem
Verapamil
Out of the 2 non-DHP CCBs, which one is more likely to cause constipation? - Answers Verapamil >
Diltiazem
,Instructions on how to use nitroglycerin SL tablets or spray. - Answers Use 1 spray or tablet when
anginal symptoms occur. Use 1 dose every 5 minutes for a total of 3 doses. If there is no improvement
after the first dose or no resolution after 3 doses, seek medical help (call ambulance)!
Characteristic side effect of nitrates. - Answers Headache!
How does verapamil interact with digoxin? - Answers Verapamil reduces the renal clearance of digoxin,
increasing digoxin levels.
Where do nitrates have their effect? - Answers Veins! Reduces afterload!
Why must individuals have a 10-12 hour nitrate-free period? - Answers To prevent tolerance!
Characteristic drug interaction with nitrates. - Answers PDE-5 Inhibitors (sildenafil, tadalafil, vardenafil)
Definition of syncope - Answers Reversible loss of consciousness not requiring resuscitative measures or
related to a seizure
Non-pharmacological options for vasovagal syncope. - Answers Increased sodium intake (3-5 grams
daily) and fluid intake (2.5 L).
Effects of fludrocortisone. - Answers Potent mineralcorticoid: retains sodium, increases loss of
potassium
Glucocorticoid effects as well
Non-pharmacological choices for orthostatic hypotension - Answers Avoid hypotensive, volume
depleting drugs as much as possible.
Increased sodium and fluid intake.
Elevate head while laying down.
Avoid hemodynamic stress (e.g. getting up too quickly).
Drug(s) that can be used for both vasovagal syncope and orthostatic hypotension. - Answers
Fludrocortisone
Midodrine (?)
MOA of midodrine - Answers Increases venous return through venoconstriction and arterial constriction
to increase blood pressure.
Drugs used for orthostatic hypotension - Answers Fludrocortisone
Indomethacin
Midodrine
, Non-selective beta-blockers
Characteristic side effect of midodrine - Answers Supine hypertension
Shivering
What class of drug does midodrine belong to? - Answers Alpha-1 adrenergic agonists
Most likely pathogen causing osteomyelitis. - Answers Staphylococcus aureus
What type of dressing for diabetic foot infections are preferred? - Answers Moist wound dressings
Initial therapy for diabetic foot infections should target which pathogens? - Answers Staphylococcus
aureus
Beta-hemolytic streptococci
Ertapenem is a broad spectrum antibiotic. Describe its activity. - Answers Active against: Gram-positive,
Gram-negative, Anaerobes
INEFFECTIVE against: Pseudomonas aeruginosa, MRSA, enterococci
Difference between imipenem or meropenem and ertapenem in regards to their activity. - Answers
Imipenem and meropenem is active against P. aeruginosa while ertapenem is not!
True or False: Carbapenems can be used against MRSA. - Answers FALSE!
Activity of first generation cephalosporins. - Answers Mostly gram-positive, some gram-negative.
Improvements in second generation cephalosporins vs. first generation. - Answers More activity against
gram-negative. Activity against anaerobes.
Difference between cefuroxime and cefoxitin. - Answers Cefuroxime does not have activity against
anaerobes.
Difference between ceftazidime and ceftriaxone in terms of activity. - Answers Ceftazidime can be used
against P. aeruginosa but ceftriaxone cannot!
Notable activity of ciprofloxacin. - Answers Gram-negative bacteria
Pseudomonas aeruginosa
Red man syndrome can occur in which antibiotic? - Answers Vancomycin causes histamine release if
infused in less than 1 hour.
Characteristic activity of vancomycin. - Answers MRSA and other gram positive bacteria.
Which CYP-interacting drugs increase the levels of propranolol and metoprolol? - Answers CYP2D6
inhibitors (e.g. amiodarone, paroxetine)
How does digoxin benefit CHF? Atrial fibrillation? - Answers Digoxin is a mild positive ionotrope to help
HF and is a negative chronotrope to help Afib.
Which beta-blocker is more likely to cause CNS side effects, such as depression and insomnia? Why -
Answers Propranolol will have more CNS side effects due to its greater lipid solubility and ability to cross
the BBB.
Name 4 cardioselective beta-blockers. What are the implications of this selectivity? - Answers Atenolol
Acebutolol
Bisoprolol
Metoprolol
Higher selectivity means less non-cardiac side effects, such as bronchospasm.
Which 2 beta blockers have intrasympathetic activity or ISA? What are the implications of this? -
Answers Pindolol
Acebutolol
This may be preferred beta blocker agents in patients that are already bradycardic at rest as they have
less effect on the heart rate.
The 3 DHP-CCBs. - Answers Amlodipine
Felodipine
Nifedipine
Characteristics side effects of DHP-CCBs. - Answers Ankle edema
Flushing
The 2 non-DHP-CCBs - Answers Diltiazem
Verapamil
Out of the 2 non-DHP CCBs, which one is more likely to cause constipation? - Answers Verapamil >
Diltiazem
,Instructions on how to use nitroglycerin SL tablets or spray. - Answers Use 1 spray or tablet when
anginal symptoms occur. Use 1 dose every 5 minutes for a total of 3 doses. If there is no improvement
after the first dose or no resolution after 3 doses, seek medical help (call ambulance)!
Characteristic side effect of nitrates. - Answers Headache!
How does verapamil interact with digoxin? - Answers Verapamil reduces the renal clearance of digoxin,
increasing digoxin levels.
Where do nitrates have their effect? - Answers Veins! Reduces afterload!
Why must individuals have a 10-12 hour nitrate-free period? - Answers To prevent tolerance!
Characteristic drug interaction with nitrates. - Answers PDE-5 Inhibitors (sildenafil, tadalafil, vardenafil)
Definition of syncope - Answers Reversible loss of consciousness not requiring resuscitative measures or
related to a seizure
Non-pharmacological options for vasovagal syncope. - Answers Increased sodium intake (3-5 grams
daily) and fluid intake (2.5 L).
Effects of fludrocortisone. - Answers Potent mineralcorticoid: retains sodium, increases loss of
potassium
Glucocorticoid effects as well
Non-pharmacological choices for orthostatic hypotension - Answers Avoid hypotensive, volume
depleting drugs as much as possible.
Increased sodium and fluid intake.
Elevate head while laying down.
Avoid hemodynamic stress (e.g. getting up too quickly).
Drug(s) that can be used for both vasovagal syncope and orthostatic hypotension. - Answers
Fludrocortisone
Midodrine (?)
MOA of midodrine - Answers Increases venous return through venoconstriction and arterial constriction
to increase blood pressure.
Drugs used for orthostatic hypotension - Answers Fludrocortisone
Indomethacin
Midodrine
, Non-selective beta-blockers
Characteristic side effect of midodrine - Answers Supine hypertension
Shivering
What class of drug does midodrine belong to? - Answers Alpha-1 adrenergic agonists
Most likely pathogen causing osteomyelitis. - Answers Staphylococcus aureus
What type of dressing for diabetic foot infections are preferred? - Answers Moist wound dressings
Initial therapy for diabetic foot infections should target which pathogens? - Answers Staphylococcus
aureus
Beta-hemolytic streptococci
Ertapenem is a broad spectrum antibiotic. Describe its activity. - Answers Active against: Gram-positive,
Gram-negative, Anaerobes
INEFFECTIVE against: Pseudomonas aeruginosa, MRSA, enterococci
Difference between imipenem or meropenem and ertapenem in regards to their activity. - Answers
Imipenem and meropenem is active against P. aeruginosa while ertapenem is not!
True or False: Carbapenems can be used against MRSA. - Answers FALSE!
Activity of first generation cephalosporins. - Answers Mostly gram-positive, some gram-negative.
Improvements in second generation cephalosporins vs. first generation. - Answers More activity against
gram-negative. Activity against anaerobes.
Difference between cefuroxime and cefoxitin. - Answers Cefuroxime does not have activity against
anaerobes.
Difference between ceftazidime and ceftriaxone in terms of activity. - Answers Ceftazidime can be used
against P. aeruginosa but ceftriaxone cannot!
Notable activity of ciprofloxacin. - Answers Gram-negative bacteria
Pseudomonas aeruginosa
Red man syndrome can occur in which antibiotic? - Answers Vancomycin causes histamine release if
infused in less than 1 hour.
Characteristic activity of vancomycin. - Answers MRSA and other gram positive bacteria.
