A 64-year-old woman with a history of type 2 diabetes is diagnosed with heart failure. Which of the following medications would be a poor choice for controlling her diabetes?
- A. Exenatide
- B. Glyburide
- C. Nateglinide
- D. Rosiglitazone
Correct Answer: D
Rationale: Rosiglitazone can worsen heart failure due to fluid retention and edema.
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Sitagliptin has been approved for:
- A. Monotherapy in once-daily doses
- B. Combination therapy with metformin
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Sitagliptin is approved for monotherapy and with metformin , offering flexible type 2 diabetes management.
The patient is taking a drug that affects the body by increasing cellular activity. Where does this drug work on the cell?
- A. Receptor sites
- B. Cell membrane
- C. Golgi body
- D. Endoplasmic reticulum
Correct Answer: A
Rationale: Many drugs are thought to act at specific areas on cell membranes called receptor sites. After the receptor site is activated, this in turn activates the enzyme systems to produce certain effects, such as increased or decreased cellular activity, changes in cell membrane permeability, or alterations in cellular metabolism. Receptor sites are generally located on the outside of cells and allow the drug to bypass the cell membrane. The Golgi body and endoplasmic reticulum are not involved in this process.
Grapefruit juice contains furanocoumarins that have been found to:
- A. Alter absorption of drugs through competition for binding sites
- B. Inhibit CYP 3A4, leading to decreased first-pass metabolism of drugs
- C. Alter vitamin K metabolism, leading to prolonged bleeding
- D. Enhance absorption of calcium and vitamin D
Correct Answer: B
Rationale: Furanocoumarins in grapefruit juice inhibit CYP3A4, reducing first-pass metabolism and increasing drug levels (e.g., statins).
A nurse is caring for a client who has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?
- A. Orthostatic hypotension
- B. Hearing loss
- C. Gastrointestinal bleeding
- D. Weight loss
Correct Answer: A
Rationale: Phenelzine, an MAOI, commonly causes orthostatic hypotension due to its effect on blood pressure regulation.
Which action would the FDA take to expedite drug development and approval for an outbreak of smallpox?
- A. List smallpox as a health orphan disease
- B. Omit the preclinical research phase
- C. Extend the clinical research phase
- D. Fast track the investigational drug
Correct Answer: D
Rationale: Fast tracking prioritizes the drug within the FDA, expediting development for urgent needs like a smallpox outbreak. Orphan disease status, omitting preclinical phases, or extending clinical phases would not align with rapid response needs.