Indications And Dosing Regimens Practice Test

A 48-year-old man (110 kg, 178 cm) with type 2 diabetes and albuminuria is being considered for an ACE inhibitor for renal protection. Current medications: amlodipine 10 mg PO daily, metformin 1000 mg PO BID. Allergies: none. Labs: urine albumin-to-creatinine ratio 220 mg/g, SCr 1.0 mg/dL, K 4.4 mEq/L, BP 138/84 mmHg. Which medication is indicated to slow progression of diabetic kidney disease in this patient?

A 58-year-old female (74 kg, 165 cm) with nonvalvular atrial fibrillation is seen in clinic for anticoagulation selection. Current medications: diltiazem ER 240 mg PO daily, hydrochlorothiazide 25 mg PO daily, omeprazole 20 mg PO daily. Allergies: none. History: hypertension, chronic kidney disease stage 4. Labs: SCr 2.6 mg/dL (0.6–1.1), estimated CrCl 22 mL/min, AST/ALT 28/24 U/L (normal), Hgb 12.4 g/dL. She has no mechanical heart valve and no moderate-to-severe mitral stenosis. What is the appropriate dosing regimen for this medication (apixaban) for stroke prevention in this patient?