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NBME 21 Answers

nbme21/Block 2/Question#28 (14.5 difficulty score)
A 64-year-old woman with type 2 diabetes ...

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submitted by haliburton(192),
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FA :0271 Fbretia RsDA ndiulec oytamhyp aeisrdenc risk hitw ast,snti selelchtoor gsllnaoste

 +1  upvote downvote
submitted by lovebug(3),

this patient began rosuvastatin tx 4 weeks ago.

rosuvastatin, pitavastatin, pravastatin are substrates for the organic anion transporting polypeptide (OATP). however, none of these 3 statins are substrates of CYP3A4.

OATP transports the statin from the plasma into the hepatocyte. The statin can then be metabolized by hepatic enzymes or transported into the bile for elimination via the gastrointestinal tract.

Interference with OATP activity results in accumulation of statin in the plasma and may lead to myopathy.

FA 2019, 315 pg

5thgencephalosporin  this is PharmD–level shiz +1  

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submitted by kevin(3),

statin + fibrate = myopathy. possibly most HY pharm principle tested