Nokea
After a few weeks on a drug, a patient reports profound thirst and the production of large volumes of dilute urine (polyuria). Which of the following drugs is most likely responsible for the symptoms?
- A. Diazepam
- B. Fluoxetine
- C. Haloperidol
- D. Lithium
Correct Answer: D
Rationale: Lithium causes nephrogenic diabetes insipidus, leading to thirst and polyuria.
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Enterohepatic circulation is seen in
- A. Ampicillin
- B. Benzylpenicillin
- C. Norfloxacin
- D. Streptomycin
Correct Answer: D
Rationale: Streptomycin is excreted via bile and reabsorbed, unlike the others.
Km value indicates
- A. Purity of enzyme
- B. Physiological role
- C. Half life enzyme drug complex
- D. Affinity
Correct Answer: C
Rationale: Km (Michaelis constant) reflects the substrate concentration at half-maximum velocity, indicating enzyme-drug complex half-life.
Prior to prescribing metformin, the provider should:
- A. Draw a serum creatinine to assess renal function
- B. Try the patient on insulin
- C. Tell the patient to increase iodine intake
- D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions
Correct Answer: A
Rationale: Metformin requires renal function assessment (creatinine) due to lactic acidosis risk; insulin isn't a prerequisite.
A nurse is caring for a 77-year-old patient. The nurse plans care for this patient based on the knowledge that the aging process impacts drug therapy in what important way?
- A. Blood volume decreases
- B. Subcutaneous tissue increases
- C. Total body water increases
- D. Muscle mass increase
Correct Answer: A
Rationale: Decreased blood volume in aging affects drug distribution and concentration.
The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.