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.
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Which of the following is corresponding to the following statement: this drug is used for diabetes mellitus and while using there is an increased risk of pancreatitis:
- A. Miglitol
- B. Pioglitazon
- C. Exenatide
- D. Glimepiride
Correct Answer: C
Rationale: Exenatide, a GLP-1 agonist, treats diabetes and has a known risk of pancreatitis as a rare but serious side effect.
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 .
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.
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments?
- A. The medication is an antibacterial.'
- B. The medication will help heal the burn.'
- C. The medication will permanently stain my skin.'
- D. The medication should be applied directly to the wound.'
Correct Answer: C
Rationale: Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in healing. It does not stain the skin.
Cecil and his wife are traveling to Southeast Asia on vacation and he has come into the clinic to review his medications. He is healthy with only mild hypertension that is well controlled. He asks about getting 'a shot' to prevent blood clots like his friend Ralph did before international travel. The correct response would be:
- A. Administer one dose of low-molecular weight heparin 24 hours before travel
- B. Prescribe one dose of warfarin to be taken the day of travel
- C. Consult with a hematologist regarding a treatment plan for Cecil
- D. Explain that Cecil is not at high risk of a blood clot and provide education about how to prevent blood clots while traveling
Correct Answer: D
Rationale: Cecil's low risk doesn't warrant prophylaxis; education on hydration and movement suffices. Heparin or warfarin is overkill without indication.