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A patient with treatment-resistant schizophrenia is started on clozapine. What is the most important baseline test? 

A 64-year-old man with ischemic cardiomyopathy (LVEF 25%) presents with dyspnea on exertion and peripheral edema. He is initiated on lisinopril, carvedilol, and spironolactone, consistent with guideline-directed medical therapy for HFrEF. Which additional medication would be expected to improve symptoms of volume overload but is not associated with a reduction in mortality? 

A 72-year-old woman with hypertension and osteoarthritis is prescribed digoxin. Her renal function shows eGFR 28 mL/min. What adjustment is most critical? 

Which drug type requires especially close therapeutic monitoring? 

Flumazenil is used in benzodiazepine overdose but should be given cautiously because: 

A patient receiving naloxone infusion for opioid overdose develops severe withdrawal. Which explains this? 

A 34-year-old man with panic disorder is prescribed alprazolam. After 6 months, he reports escalating doses and withdrawal when he misses a dose. What has occurred? 

A patient on donepezil develops dizziness and a heart rate of 48 bpm. This is most likely due to: 

A 28-year-old woman presents with recurrent migraines. Which is most appropriate for acute attacks? 

A 39-year-old with bipolar disorder is stable on lithium. Labs show creatinine 2.0 mg/dL. What is the most appropriate action?