NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What adjustment should be made when a patient is immunosuppressed with steroids?

1. Increase dosage by 10-20%

2. Reduce dosage by 10-20% every few days

3. No changes needed

4. Double the dosage immediately

The correct answer is: Reduce dosage by 10-20% every few days

When a patient is immunosuppressed with steroids, it is important to reduce the dosage gradually over time. Abruptly stopping or making significant dosage adjustments can lead to adrenal insufficiency or an adrenal crisis. Gradually tapering the dosage allows the adrenal glands to resume their normal function and helps prevent withdrawal symptoms. Therefore, reducing the dosage by 10-20% every few days is the appropriate adjustment to make in this situation. Option A (increasing the dosage by 10-20%) is incorrect because increasing the dosage may further suppress the immune system and lead to potential adverse effects. Option C (no changes needed) is incorrect because patients who are immunosuppressed with steroids require careful monitoring and dosage adjustments to prevent complications. Option D (doubling the dosage immediately) is incorrect because doubling the dosage abruptly can have serious consequences such as worsening the immunosuppression and increasing the risk of side effects.