Following drugs have disulfiram-like reaction when taken with alcohol EXCEPT
- A. Sulfonylureas
- B. Amoxicillin
- C. Metronidazole
- D. Cefoperazone
Correct Answer: B
Rationale: Metronidazole, cefoperazone, and some sulfonylureas cause a disulfiram-like reaction (flushing, nausea) with alcohol by inhibiting aldehyde dehydrogenase; amoxicillin does not.
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A young adult female who is taking metronidazole (Flagyl) to treat trichomoniasis calls the nurse to report severe headache, flushing, palpitations, cramping, and nausea. What will the nurse do next?
- A. Ask about alcohol consumption
- B. Reassure her that these are harmless side effects
- C. Tell her that this signals a worsening of her infection
- D. Tell her to go to the emergency department immediately
Correct Answer: A
Rationale: Metronidazole with alcohol causes a disulfiram-like reaction (symptoms listed); it's not infection worsening or harmless . Patients who are taking metronidazole can experience a disulfiram-like reaction when they drink alcohol.
Which of the following is an insulin effect in the liver:
- A. Inhibition of glycogenolisis
- B. Inhibition of glycolysis
- C. Decrease of glycogenesis
- D. Decreases of pyruvatkinase, phosphofructokinase and glucokinase activity
Correct Answer: A
Rationale: Insulin inhibits glycogenolysis in the liver, promoting glucose storage as glycogen rather than its breakdown.
Cynthia is taking valproate (Depakote) for seizures and would like to get pregnant. What advice would you give her?
- A. Valproate is safe during all trimesters of pregnancy.
- B. She can get pregnant while taking valproate, but she should take adequate folic acid.
- C. Valproate is not safe at any time during pregnancy.
- D. Valproate is a known teratogen, but may be taken after the first trimester if necessary.
Correct Answer: D
Rationale: Valproate is teratogenic (e.g., neural tube defects) but may be used post-first trimester if essential.
Acetyl salicylate & phenobarbitone are better absorbed from stomach because they are
- A. Weak acids remain non-ionic in gastric pH
- B. Weak acids remain ionic in gastric pH
- C. Strong acids fully ionized in gastric pH
- D. Weak bases which are ionized at gastric pH
Correct Answer: A
Rationale: Weak acids like acetyl salicylate (aspirin) and phenobarbitone remain non-ionic in the acidic pH of the stomach, facilitating their absorption through passive diffusion across the gastric mucosa.
Drugs mostly cross biological membranes by
- A. Passive diffusion
- B. Active diffusion
- C. Active transport
- D. Carrier mediated transport
Correct Answer: A
Rationale: Most drugs cross membranes via passive diffusion based on concentration gradients.