Therapeutic Duplication - Pharmacy Technician Certification Exam Ptce

  1. Identify the duplication: atorvastatin plus rosuvastatin.
    Statin duplication. Atorvastatin and rosuvastatin both inhibit HMG-CoA reductase, causing overlapping cholesterol reduction and increased risk of myopathy or rhabdomyolysis.
  2. Identify the duplication: aspirin daily plus clopidogrel without a clear indication.
    Antiplatelet duplication (dual antiplatelet therapy). Aspirin and clopidogrel both inhibit platelet aggregation via different pathways, but without indication, this overlaps antiplatelet effects and increases bleeding risk.
  3. Identify the duplication: lisinopril plus losartan used together routinely.
    RAAS duplication (ACE inhibitor + ARB). Combining an ACE inhibitor with an ARB redundantly inhibits the renin-angiotensin-aldosterone system, increasing risks such as hyperkalemia without routine justification.
  4. Which duplication is present: apixaban plus rivaroxaban?
    DOAC duplication. Apixaban and rivaroxaban are both direct oral anticoagulants targeting factor Xa, leading to redundant inhibition of coagulation and elevated hemorrhage potential.
  5. Which duplication is present: diltiazem plus verapamil?
    Non-dihydropyridine calcium channel blocker duplication. Diltiazem and verapamil both inhibit calcium channels in a non-dihydropyridine manner, leading to redundant effects on heart rate and conduction with risk of bradycardia.
  6. Which duplication is present: zolpidem plus eszopiclone?
    Non-benzodiazepine hypnotic duplication (Z-drugs). Zolpidem and eszopiclone both act as non-benzodiazepine hypnotics on GABA receptors, leading to redundant sleep induction and potential for next-day impairment.
  7. Which duplication is present: amlodipine plus nifedipine ER?
    Dihydropyridine calcium channel blocker duplication. Amlodipine and nifedipine ER both act as dihydropyridine calcium channel blockers, providing overlapping vasodilation and risking excessive hypotension.
  8. Which duplication is present: albuterol inhaler plus levalbuterol inhaler?
    SABA duplication. Albuterol and levalbuterol both activate short-acting beta-2 receptors for bronchodilation, causing redundant asthma relief and risks like tachycardia.
  9. Which duplication is present: losartan plus valsartan?
    ARB duplication. Losartan and valsartan both block angiotensin II receptors, causing overlapping antihypertensive effects and potential for additive adverse reactions like hypotension.
  10. Identify the duplication: hydrochlorothiazide plus chlorthalidone.
    Thiazide diuretic duplication. Hydrochlorothiazide and chlorthalidone both promote sodium and water excretion via thiazide mechanisms, causing redundant diuresis and electrolyte imbalances like hypokalemia.
  11. Which duplication is present: metoprolol plus carvedilol?
    Beta-blocker duplication. Metoprolol and carvedilol both block beta-adrenergic receptors, resulting in redundant heart rate and blood pressure control with amplified side effects like bradycardia.
  12. Which duplication is most concerning: lisinopril plus enalapril?
    ACE inhibitor duplication. Both lisinopril and enalapril inhibit angiotensin-converting enzyme, leading to redundant blood pressure lowering and heightened risk of hyperkalemia or renal issues.
  13. Which duplication is present: famotidine plus cimetidine?
    H2-receptor antagonist duplication. Famotidine and cimetidine both block histamine-2 receptors in the stomach, resulting in redundant acid reduction and potential for drug interactions or confusion.
  14. Which duplication is present: escitalopram plus venlafaxine used together routinely?
    Serotonergic antidepressant duplication (SSRI + SNRI). Escitalopram (SSRI) and venlafaxine (SNRI) both enhance serotonergic transmission, causing redundant mood stabilization but heightening serotonin-related adverse effects.
  15. Identify the duplication: omeprazole plus pantoprazole.
    Proton pump inhibitor duplication. Omeprazole and pantoprazole both irreversibly inhibit the proton pump in gastric cells, causing overlapping acid suppression and risks like hypomagnesemia.
  16. Which duplication is present: warfarin plus apixaban?
    Therapeutic anticoagulant duplication. Warfarin and apixaban both prevent blood clot formation through different mechanisms, but their combined use overlaps anticoagulation therapy, raising bleeding risks.
  17. Which duplication is present: celecoxib plus meloxicam?
    NSAID duplication (COX-2 selective plus NSAID). Celecoxib selectively inhibits COX-2 while meloxicam has partial selectivity, but both provide NSAID effects, leading to redundant pain relief and cardiovascular risks.
  18. Which duplication is present: ibuprofen plus naproxen?
    NSAID duplication. Ibuprofen and naproxen both inhibit cyclooxygenase enzymes non-selectively, resulting in overlapping anti-inflammatory effects and amplified gastrointestinal toxicity.
  19. Identify the duplication: lorazepam plus alprazolam.
    Benzodiazepine duplication. Lorazepam and alprazolam both enhance GABA activity via benzodiazepine receptors, resulting in overlapping anxiolytic effects and risks of sedation or dependence.
  20. Identify the duplication: sertraline plus fluoxetine.
    SSRI duplication. Sertraline and fluoxetine both selectively inhibit serotonin reuptake, leading to overlapping antidepressant effects and increased risk of serotonin syndrome.
  21. Identify the duplication: furosemide plus bumetanide.
    Loop diuretic duplication. Furosemide and bumetanide both inhibit the Na-K-2Cl cotransporter in the loop of Henle, resulting in overlapping potent diuresis and risks such as ototoxicity.
  22. Identify the duplication: hydrocodone-acetaminophen plus oxycodone-acetaminophen.
    Duplicate opioid plus duplicate acetaminophen exposure. These combinations overlap opioid analgesia while exceeding safe acetaminophen limits, increasing risks of respiratory depression and hepatotoxicity.
  23. Identify the duplication: Advair (fluticasone/salmeterol) plus Symbicort (budesonide/formoterol).
    Duplicate ICS/LABA therapy. Advair and Symbicort both combine an inhaled corticosteroid with a long-acting beta agonist, providing overlapping asthma control and risks of thrush or tachycardia.
  24. Which duplication is present: spironolactone plus eplerenone?
    Aldosterone antagonist duplication. Spironolactone and eplerenone both antagonize aldosterone receptors, leading to redundant potassium-sparing diuresis and heightened risk of hyperkalemia.

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