Nokea
A 59-year-old man complains of nocturia, urinary frequency, and an inability to urinate forcefully and empty his bladder. Following a complete workup, he was diagnosed with benign prostatic hypertrophy (BPH). We start daily therapy with tamsulosin. Which of the following is the most likely side effect the patient may experience from the tamsulosin, and about which he should be forewarned?
- A. Bradycardia
- B. Increased risk of statin-induced skeletal muscle pathology
- C. First dose hypotension
- D. Photophobia and other painful responses to bright lights
Correct Answer: C
Rationale: The correct answer is C: First dose hypotension. Tamsulosin is an alpha-1 blocker commonly used for BPH. It can cause orthostatic hypotension, especially after the first dose due to sudden vasodilation. This side effect is important to be forewarned about to prevent falls or accidents. Bradycardia (choice A) is not a common side effect of tamsulosin. Increased risk of statin-induced skeletal muscle pathology (choice B) is unrelated to tamsulosin. Photophobia and painful responses to bright lights (choice D) are not associated with tamsulosin use.
You may also like to solve these questions
Which row shows active transport?
- A. particles move from high concentration to low concentration, particles move from low concentration to high concentration, requires energy
- B. particles move from high concentration to low concentration, particles move from low concentration to high concentration, requires energy
- C. particles move from high concentration to low concentration, particles move from low concentration to high concentration, requires energy
- D. particles move from high concentration to low concentration, particles move from low concentration to high concentration, requires energy
Correct Answer: C
Rationale: The correct answer is C because active transport involves the movement of particles from low concentration to high concentration, which goes against the natural flow of diffusion and requires energy input. In active transport, cells use ATP to pump substances across the cell membrane against their concentration gradient. This process allows cells to accumulate essential molecules or ions that are needed in higher concentrations inside the cell. Choices A, B, and D all describe passive transport processes where particles move with the concentration gradient and do not require energy input.
Which of the following drugs is a direct stimulant of β1 and β2 adrenoceptors:
- A. Noradrenaline
- B. Isoprenaline
- C. Salbutamol
- D. Amphetamine
Correct Answer: B
Rationale: The correct answer is B: Isoprenaline. Isoprenaline directly stimulates both β1 and β2 adrenoceptors. It is a non-selective β-adrenergic agonist, leading to increased heart rate (β1 stimulation) and bronchodilation (β2 stimulation).
Incorrect choices:
A: Noradrenaline mainly acts on α-adrenoceptors.
C: Salbutamol is a selective β2 agonist, not stimulating β1 receptors.
D: Amphetamine primarily acts on catecholamine release and reuptake inhibition, not direct β-adrenoceptor stimulation.
Verapamil is a drug used for treating hypertension. It should be used with caution with other drugs that can depress heart rate or contractility. Which drug, if given with verapamil, might therefore cause the greatest risk of depressing heart rate, contractile force, or impulse conduction?
- A. Albuterol
- B. Scopolamine
- C. Propranolol
- D. Isoproterenol
Correct Answer: C
Rationale: The correct answer is C: Propranolol. Verapamil is a calcium channel blocker that can depress heart rate and contractility. Propranolol is a beta-blocker that also decreases heart rate and contractile force. When combined, both drugs can have an additive effect leading to a significant decrease in heart rate and contractility, potentially causing bradycardia or heart failure.
Albuterol (A) is a beta-2 agonist that actually increases heart rate and contractility. Scopolamine (B) is an anticholinergic drug that may decrease heart rate, but its effect is not as significant as propranolol. Isoproterenol (D) is a beta agonist that increases heart rate and contractility, so its combination with verapamil would not pose the same risk as propranolol.
All the following adverse effects can be produced by beta-blockers EXCEPT:
- A. Hypotension
- B. Heart failure
- C. Bronchodilation
- D. Heart block
Correct Answer: C
Rationale: The correct answer is C: Bronchodilation. Beta-blockers primarily work by blocking the beta-adrenergic receptors, leading to a decrease in heart rate and contractility. This can result in adverse effects such as hypotension, heart failure, and heart block due to the reduced cardiac output. However, bronchodilation is not a typical adverse effect of beta-blockers. In fact, beta-blockers can cause bronchoconstriction in patients with underlying respiratory conditions like asthma, making choice C the correct answer. Choices A, B, and D are incorrect because hypotension, heart failure, and heart block are known adverse effects associated with beta-blockers due to their mechanism of action on the cardiovascular system.
Elderly people are more likely to develop type 2 diabetes due to the decline in production.
- A. estrogen
- B. thyroid hormone
- C. follicle-stimulating hormone
- D. insulin
Correct Answer: D
Rationale: The correct answer is D: insulin. Elderly individuals are more likely to develop type 2 diabetes due to a decrease in insulin production by the pancreas and decreased sensitivity to insulin in tissues. Insulin plays a crucial role in regulating blood sugar levels by facilitating the uptake of glucose into cells for energy production. A decline in insulin production or sensitivity can lead to elevated blood sugar levels, contributing to the development of type 2 diabetes. Estrogen (choice A), thyroid hormone (choice B), and follicle-stimulating hormone (choice C) do not directly impact insulin production or sensitivity in the context of type 2 diabetes development in elderly individuals.