Pharmacy PEBC Practice Exam

HM is a regular client at the pharmacy. He has been taking quetiapine 300 mg po bid for 8 months to help control his schizophrenia symptoms but he has recently noticed that some of his symptoms have been worsening. Prior to starting quetiapine, HM took risperidone therapy for 2 years. HM is a regular smoker and smokes between 10-20 cigarettes per day. HM tells the pharmacist that now his psychiatrist would like to change his regimen to clozapine. In assessing the possible change to clozapine for HM, which of the following statements is the most appropriate for the pharmacist to consider?

1. This change is appropriate, as clozapine may help patients who fail on other antipsychotics.

2. This change is not appropriate, as clozapine will likely produce the same effect as quetiapine.

3. This change is not appropriate, as the cost of monitoring and risk of adverse effects with clozapine is too high.

4. This change is not appropriate, because the preferred recommendation is to add clozapine to the current quetiapine.

The correct answer is: This change is appropriate, as clozapine may help patients who fail on other antipsychotics.

In this scenario, clozapine is being considered as an alternative to quetiapine. Option B is incorrect because clozapine works differently than quetiapine and may be more effective for HM's specific symptoms. Option C is incorrect because while there are potential risks and costs associated with clozapine, the decision to change medications should be based on the individual's needs and not solely on cost. Option D is incorrect because adding a new medication to an existing one can potentially lead to more side effects and interactions, making it a less favorable option compared to switching to clozapine. Therefore, it is most appropriate for the pharmacist to consider changing to clozapine as it may be more beneficial for HM's symptoms.