Cardiovascular Pharmacology Drug Class

Cardiovascular Pharmacology Drug Class Related

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A patient who has received lithium for 3 weeks to control acute mania has the following symptoms: coarse hand tremor, diarrhea, vomiting, lethargy, and mild confusion. The priority nursing action should be to:

  • A. Administer prn Cogentin to relieve the symptoms.
  • B. Provide reassurance that the symptoms are transient.
  • C. Obtain a stat lithium level; hold lithium pending results.
  • D. Assist the patient to decrease the sodium in their daily diet.
Correct Answer: C

Rationale: Correct Answer: C
Rationale:
1. The patient is showing signs of lithium toxicity, indicated by symptoms like tremors, diarrhea, vomiting, lethargy, and confusion.
2. Obtaining a stat lithium level is crucial to confirm toxicity levels.
3. Holding lithium pending results prevents further toxicity and guides appropriate treatment adjustments.
4. Administering Cogentin (A) may mask symptoms but does not address the underlying issue of lithium toxicity.
5. Providing reassurance (B) is important but not the priority when the patient is experiencing potential toxicity.
6. Assisting the patient to decrease sodium intake (D) is not the priority as it does not address the immediate need to manage lithium toxicity.

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Choose the drug which has a direct effect on platelet membrane to inhibit aggregation, release reaction and to improve platelet survival in extra-corporeal circulation

  • A. Dipyridamole
  • B. Ticlopidine
  • C. Aspirin
  • D. Sulfinpyrazone
Correct Answer: B

Rationale: Ticlopidine acts directly on the platelet membrane by inhibiting ADP-induced aggregation and release reactions, and it improves platelet survival in extracorporeal circulation, unlike the other options which have different primary mechanisms.

Regarding the mechanism of action of hormones indicate the FALSE statement:

  • A. Hormones interact with the specific receptors in the wall of the cells
  • B. Cyclic AMP acts as a second messenger system
  • C. They stimulate adenylcyclase enzyme
  • D. Many hormones owe their effect to primary actions on subcellular membrane.
Correct Answer: D

Rationale: The correct answer is D because many hormones actually exert their effects by interacting with specific receptors on the cell membrane rather than acting directly on subcellular membranes. This interaction triggers a series of intracellular events that lead to a cellular response. Option A is true as hormones indeed interact with specific receptors on cell walls. Option B is true as cyclic AMP is a common second messenger system utilized by hormones. Option C is true as many hormones stimulate adenylcyclase enzyme as part of their signaling pathway.

Indicate the antiseizure drug, which is a sulfonamide derivative, blocking Na+ channels and having additional ability to inhibit T-type Ca2+ channels:

  • A. Tiagabine
  • B. Zonisamide
  • C. Ethosuximide
  • D. Primidone
Correct Answer: B

Rationale: The correct answer is B: Zonisamide. Zonisamide is a sulfonamide derivative that blocks Na+ channels and also inhibits T-type Ca2+ channels. This dual mechanism of action helps in controlling seizures. Tiagabine (A) inhibits GABA reuptake, Ethosuximide (C) blocks T-type Ca2+ channels only, and Primidone (D) is metabolized into phenobarbital, which enhances GABAergic activity.

Which of the following benzodiazepines is used mainly for hypnosis?

  • A. Clonozepam
  • B. Lorazepam
  • C. Flurazepam
  • D. Midazolam
Correct Answer: C

Rationale: The correct answer is C: Flurazepam. Flurazepam is a benzodiazepine commonly used for its sedative-hypnotic properties, making it ideal for treating insomnia and inducing sleep. Clonazepam (A) is mainly used for seizure disorders and panic disorder. Lorazepam (B) is primarily used for anxiety and agitation. Midazolam (D) is commonly used for sedation before medical procedures. Therefore, Flurazepam is the most appropriate choice for hypnosis among the options provided.

Which of the following mediators is found mainly in long descending pathways from the midbrain to the dorsal horn?

  • A. Prostaglandin E
  • B. Dynorphin
  • C. Enkephalin
  • D. Glutamate
Correct Answer: B

Rationale: The correct answer is B: Dynorphin. Dynorphin is mainly found in long descending pathways from the midbrain to the dorsal horn. It acts as an endogenous opioid peptide that modulates pain perception. Prostaglandin E, Enkephalin, and Glutamate are not primarily found in these pathways. Prostaglandin E is involved in inflammation and fever, Enkephalin acts as an endogenous opioid peptide in pain modulation, and Glutamate is a major excitatory neurotransmitter in the central nervous system. Thus, B is the correct choice based on its specific localization in the described pathways.