Womens Mens Health>Contraindication Identification Practice Test

A 28-year-old G1P0 at 9 weeks gestation presents to the pharmacy seeking help for moderate inflammatory acne that has worsened since becoming pregnant. She has tried gentle cleansers and oil-free moisturizers without relief. Medical history is unremarkable, and she takes a prenatal vitamin with folic acid. She does not smoke or drink alcohol and has no drug allergies. She asks about prescription options to clear her acne quickly because she has an upcoming event in several weeks. Her dermatologist previously mentioned both topical and oral options but asked her to confirm safety in pregnancy. Physical exam at her obstetric visit last week was normal, and fetal ultrasound was consistent with dates. The pharmacist reviews potential therapies and their safety during pregnancy.

Mr. R is a 62-year-old man with stable ischemic heart disease and hypertension who presents for erectile dysfunction management. His medications include metoprolol succinate 50 mg daily, atorvastatin 40 mg nightly, aspirin 81 mg daily, and sublingual nitroglycerin 0.4 mg as needed for chest pain (he reports using 1-2 tablets per week). Blood pressure today is 128/76 mm Hg, heart rate 64 bpm, and he denies dizziness or orthostasis. He does not use alpha-blockers. He drinks an occasional glass of wine and has normal renal and hepatic function. He asks about starting sildenafil for on-demand use. The prescriber asks the pharmacist to identify any absolute reasons not to start therapy and to provide counseling on safe use if appropriate.