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. HM is concerned about the possible adverse effects from clozapine. When discussing monitoring with HM, which of the following statements is the most appropriate to include?

1. Dry eyes and dry mouth occur frequently and may be managed with nonprescription supplements.

2. Problems affecting the blood do occur rarely and regular blood labwork is required.

3. Cigarette smoking may increase the likelihood of experiencing side effects from clozapine.

4. Parkinsonian and other movement disorders may occur even with low doses of clozapine.

The correct answer is: Problems affecting the blood do occur rarely and regular blood labwork is required.

Regular blood labwork is required when taking clozapine because it can cause problems affecting the blood, including low white blood cell count and/or agranulocytosis, which can be life-threatening. This is why it is important for HM's psychiatrist to monitor his blood regularly to ensure his treatment is safe and effective. Option A is incorrect because dry eyes and dry mouth are not major side effects of clozapine and can be managed with over-the-counter products. Option C is incorrect because while smoking can affect the metabolism of clozapine, it is not the main reason for the required monitoring. Option D is also incorrect because while movement disorders can occur with clozapine, it is not the main reason for the required monitoring.