Sample interview questions: Describe a situation where you had to provide an alternative medication therapy due to patient-specific factors.
Sample answer:
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Patient Profile:
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Name: Samuel Jones
- Age: 68 years
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Medical History: Hypertension, Diabetes, Chronic Kidney Disease
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Medication Order:
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Prescription: Lisinopril 20 mg once daily for hypertension
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Patient-Specific Factors:
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Recent history of acute kidney injury
- Serum creatinine elevated to 2.0 mg/dL
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Estimated glomerular filtration rate (eGFR) decreased to 40 mL/min/1.73 m2
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Clinical Reasoning:
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Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat hypertension. However, it is primarily eliminated by the kidneys, and dosage adjustments are necessary in patients with renal impairment to prevent drug accumulation and potential adverse effects.
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In Mr. Jones’s case, his decreased renal function, as evidenced by elevated serum creatinine and reduced eGFR, increases the risk of lisinopril accumulation, which can lead to hypotension, hyperkalemia, and worsening renal function.
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Alternative Medication Therapy:
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Given Mr. Jones’s renal impairment, an alternative antihypertensive medication with a different elimination pathway was needed to minimize the risk of adverse effects.
- After reviewing his medical history and current medications, I recommended amlodipine 5 mg once daily as a suitable alternative.
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Amlodip… Read full answer
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