Nokea
Rifampin is a nonspecific CYP450 inducer that may:
- A. Lead to toxic levels of rifampin and must be monitored closely
- B. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
- C. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
- D. Cause nonspecific changes in drug metabolism
Correct Answer: C
Rationale: Rifampin induces CYP450, speeding metabolism of drugs like oral contraceptives , reducing efficacy, not causing toxicity or nonspecificity .
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What patient populations would the nurse expect is most likely to be prescribed a drug for an off-label use?
- A. Adolescent and middle-aged adult patients
- B. Patients with diabetes or heart disease
Correct Answer: B
Rationale: Patients with chronic conditions like diabetes or heart disease are more likely to receive off-label prescriptions due to limited standard treatment options or the need for alternative therapies when conventional drugs are ineffective. Adolescents and middle-aged adults are less likely unless specific conditions warrant it, but the document cuts off, and based on clinical context, chronic disease patients are a common focus for off-label use.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
In teaching about the use of sublingual nitroglycerine, the patient should be instructed:
- A. To swallow the tablet with a full glass of water
- B. To place one tablet under the tongue if chest pain occurs and allow it to dissolve
- C. To take one tablet every 5 minutes until the chest pain goes away
- D. That it should 'burn' when placed under the tongue or it is no longer effective
Correct Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid absorption.
A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructor's best response?
- A. A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
- B. A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with some receptor sites preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.
Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following statements about this form of insulin is NOT true?
- A. Optimal time of preprandial injection is 15 minutes
- B. Duration of action is increased when the dose is increased
- C. It is compatible with neutral protamine Hagedorn insulin
- D. It has no pronounced peak
Correct Answer: B
Rationale: Lispro's duration is fixed (3-5 hours), not dose-dependent; 15-minute timing , NPH compatibility , and peakless profile are true.