Peter Attia Drugs Cardiovascular

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A teaching plan for a patient taking lithium should include instructions to:

  • A. maintain normal salt and fluids in the diet.
  • B. drink twice the usual daily amount of fluid.
  • C. have regular laboratory studies of liver function.
  • D. avoid eating aged cheese
Correct Answer: A

Rationale: Step 1: Lithium is a mood stabilizer that can cause dehydration and increase the risk of toxicity.
Step 2: Maintaining normal salt and fluids helps prevent dehydration and maintains lithium levels.
Step 3: Drinking excessive fluids (B) can lead to lithium toxicity.
Step 4: Regular liver function tests (C) are not necessary for monitoring lithium therapy.
Step 5: Avoiding aged cheese (D) is unrelated to lithium therapy.
Summary: Choice A is correct as it directly addresses the need to maintain hydration and normal salt levels to prevent lithium toxicity. Choices B, C, and D are incorrect as they are either unnecessary or unrelated to lithium therapy.

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A patient to be commenced on oral anticoagulant therapy for DVT would be treated with

  • A. Oral anticoagulant therapy with warfarin for a goal intenational normalized ration (INR) of 2-3
  • B. Oral anticoagulant therapy with warfarin for a goal INR of 2.5-3.5
  • C. Oral anticoagulant therapy with aspirin for a goal INR of 2-3
Correct Answer: A

Rationale: Warfarin with an INR goal of 2-3 is standard for DVT to balance anticoagulation and bleeding risk; aspirin does not target INR.

Which of the following instructions regarding lithium therapy should be included in a nurse’s discharge teaching? (Select the one tha does not apply.)

  • A. Avoid excessive use of beverages containing caffeine.
  • B. Maintain a consistent sodium intake.
  • C. Consume at least 2,500 to 3,000 mL of fluid per day.
  • D. Restrict sodium content.
Correct Answer: D

Rationale: The correct answer is D because lithium therapy requires a consistent sodium intake to maintain proper electrolyte balance. Restricting sodium content can lead to lithium toxicity. Choice A is important to avoid interactions with caffeine. Choice B is crucial to prevent fluctuations in sodium levels. Choice C is essential to prevent dehydration and maintain proper kidney function. Therefore, restricting sodium content is not a suitable instruction for lithium therapy.

The client asks about side effects of taking digoxin. How does the nurse respond?

  • A. Anorexia can be a side effect of digoxin.
  • B. Tachycardia can be a side effect of digoxin.
  • C. Constipation can be a side effect of digoxin.
  • D. Urinary retention can be a side effect of digoxin.
Correct Answer: A

Rationale: Anorexia, nausea, and vomiting are common early signs of digoxin toxicity due to its gastrointestinal effects; tachycardia is not typical as digoxin slows the heart rate.

Which of the following psychostimulants acts centrally mainly by blocking adenosine receptors?

  • A. Meridil
  • B. Caffeine
  • C. Amphetamine
  • D. Sydnophen
Correct Answer: B

Rationale: The correct answer is B: Caffeine. Caffeine acts centrally mainly by blocking adenosine receptors. Adenosine normally inhibits the release of neurotransmitters, but when adenosine receptors are blocked by caffeine, this inhibition is reduced, leading to increased alertness and wakefulness.

Meridil (A), Amphetamine (C), and Sydnophen (D) do not primarily act by blocking adenosine receptors. Meridil is a sympathomimetic amine, Amphetamine is a psychostimulant that primarily acts by increasing the release of dopamine and norepinephrine, and Sydnophen is a stimulant drug.

A 58-year-old man presents to the emergency department (ED) after experiencing a sudden loss of motor control on his left side accompanied by aphasia. By the time he reached the ED, his symptoms had already resolved. He is given a prescription for a drug that binds platelet ADP receptors to prevent their aggregation. Which drug is this?

  • A. Clopidogrel
  • B. Enoxaparin
  • C. Eptifibatide
  • D. Tirofiban
Correct Answer: A

Rationale: Clopidogrel inhibits ADP receptors on platelets, preventing aggregation, and is used for secondary prevention after a transient ischemic attack (TIA), as described.