The heart wants what it wants
This cardio-selective beta-1 antagonist “lowers rate, lowers output, limits angina” and is often used in HFrEF.
What is Bisoprolol?
“This contraceptive category should not be used in a 37-year-old who smokes 20 cigarettes per day and has new-onset migraine with aura. Yet, it’s commonly requested for cycle control. What is this method?”
What is combined hormonal contraception (pill, patch, or ring)?
A 42-year-old patient with asthma arrives in the clinic reporting new palpitations after increasing the frequency of their rescue inhaler. An ECG shows borderline QT prolongation. The most likely culprit of this new finding is? What would you switch this client to?
What is Salbutamol and or Formoterol? Switch to ipratropium (SAMA) or tiotropium (LAMA) if QT is a concern.
Before prescribing methadone, clinicians must be cautious about this major electrophysiologic risk.
what is QT prolongation?
This type of urinary incontinence is characterized by variable volume leakage, a sudden urge to void, and the inability to suppress that urge.
What is urge incontinence?
This dihydropyridine CCB is vasoselective and commonly used for HTN and angina.
What is Amlodapine?
This represents an absolute contraindication for the insertion of any type of Intrauterine Device (IUD)?
What is undiagnosed abnormal vaginal bleeding?
According to guidelines needing reliever therapy more than ___ doses per week is an indicator of uncontrolled asthma
What is two?
For a patient with Alcohol Use Disorder who also has severe liver disease (LFTs >5x ULN), which first-line agent would be contraindicated?
What is Naltrexone?
This medication enhances acetylcholine activity in the upper GI tract and carries a risk of tardive dyskinesia with long-term use.
What is Metoclopramide?
Why is atorvastatin preferred at night in hypercholesterolemia?
What is hepatic cholesterol synthesis peaks overnight, optimizing statin efficacy?
“You are choosing between levonorgestrel emergency contraception and an IUD for EC. The patient has untreated chlamydia today and wants something that can continue as long-term contraception. Based on contraindications, this option is not appropriate, even though it is the most effective EC. What is it?”
What is an IUD (copper or LNG) used as emergency contraception?
A patient with asthma is prescribed Formoterol. According to the guidelines, what is the most critical safety consideration regarding its use in this condition?
What is co prescribing with an ICS?
This non-stimulant ADHD option may be preferred in patients with substance use disorder, significant anxiety, or intolerance to stimulants.
What is atomoxetine or another non-stimulant?
This first-line agent for acute uncomplicated cystitis should be avoided if CrCl < 30 mL/min and also near term in pregnancy.
What is Nitrofurantoin?
These are contraindications for ACE inhibitors and ARBs in HTN management.
What is pregnancy, bilateral renal artery stenosis, history of angioedema, or hyperkalemia?
“A patient is seeking a pregancy termination. She has uncontrolled asthma and chronic renal failure. According to the absolute contraindications common to both agents in the regimen, this standard combination used for medical abortion is contraindicated. What is the combination?”
What are mifepristone + misoprostol?
“A 72-year-old patient with COPD is started on a new medication, but quickly develops worsening urinary retention and increased eye pain due to narrow-angle glaucoma. He still requires long-acting maintenance therapy. Which medication is he currently on based on this reaction and which class of bronchodilators should he be switched to?”
What is a LAMA and he should be switched to a
LABA?
This drug category includes several antiseizure medications specifically avoided in pregnancy due to neural tube defect risk.
What is Valproate?
A patient with urge incontinence and BPH-related urinary retention asks for a medication to calm bladder urgency. Which medication class should be avoided because it may worsen retention?
What are anticholinergics?
bonus points - what might you start this patient on?
Explain how SGLT2 inhibitors reduce HF hospitalization beyond glucose lowering.
What is osmotic diuresis reduces preload, lowers afterload, and improves cardiac energetics independent of glycemic effect?
“A perimenopausal patient has severe vasomotor symptoms. She has an intact uterus, a history of thromboembolism, and coronary heart disease—making systemic estrogen therapy contraindicated. Despite this, she still needs evidence-based treatment. According to the options for moderate–severe vasomotor symptoms, this category of medications is an appropriate non-hormonal alternative. What is this class?”
What are non-hormonal options such as antidepressants, gabapentinoids, or clonidine?
According to the provided treatment guidelines for asthma, if a patient's symptoms are uncontrolled on a daily Inhaled Corticosteroid (ICS) and a rescue SABA, this medication should be added?
What is a long acting Beta2 agonist (LABA)?
A 32-year-old woman with new-onset episodes of sudden behavioral arrest and eyelid fluttering is diagnosed with absence seizures. Her clinician avoids a medication that is otherwise first-line for several generalized seizure types due to its teratogenicity and plans a drug with a completely different mechanism of action. Later, when her generalized tonic-clonic seizures emerge, a second agent is added—one that is safe in pregnancy and also effective across multiple generalized seizure types.
Based on treatment principles, contraindications, and mechanism diversity, name BOTH medications selected for her initial and subsequent therapy.
What are?
Ethosuximide (initial absence seizure treatment, avoids teratogenic valproate, different MoA
Lamotrigine (added for generalized tonic-clonic, pregnancy-safe, cross-generalized efficacy)
This H. pylori treatment strategy requires using multiple medications at the same time, including a PPI and agents that directly target the organism, to achieve eradication.
What is Quadruple therapy for 14 days?
PPI (BID) + bismuth subsalicylate (2 tabs QID) + metronidazole (500 mg TID-QID) + tetracycline 500 mg QID