All increase dopaminergic transmission except
- A. Bromocriptine
- B. Metoclopramide
- C. Chlorpromazine
- D. Reserpine
Correct Answer: B
Rationale: Metoclopramide blocks dopamine receptors; others affect dopamine differently.
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A patient presents in the emergency department with a massive overdose of a drug. The most worrisome signs and symptoms include excessive cardiac stimulation (severe tachycardia, palpitations, angina, etc.). The EDphysician orders IV administration a -adrenergic blocker, saying (correctly) it is the only drug likely to normalize cardiac function quickly and save the patient's life. Which of the following was the most likely drug the patient overdosed on?
- A. A second-generation sulfonylurea (e.g., glipizide, glyburide)
- B. Insulin
- C. Levothyroxine
- D. Prednisone (oral glucocorticoid)
Correct Answer: C
Rationale: Levothyroxine overdose causes thyrotoxicosis, leading to cardiac overstimulation treatable with beta-blockers.
Niaspan is less likely to cause which side effect that is common to niacin?
- A. Gastrointestinal irritation
- B. Cutaneous flushing
- C. Dehydration
- D. Headaches
Correct Answer: B
Rationale: Niaspan's extended-release form reduces flushing compared to immediate-release niacin.
Ciprofloxacin otic drops are contraindicated in:
- A. Children
- B. Patients with acute otitis externa
- C. Patients with a perforated tympanic membrane
- D. Swimmer's ear
Correct Answer: C
Rationale: Ciprofloxacin otic risks ototoxicity with perforated eardrums; it's safe in kids or swimmer's ear .
Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:
- A. Slurred speech and insomnia
- B. Bradycardia and confusion
- C. Dizziness and orthostatic hypotension
- D. Insomnia and decreased appetite
Correct Answer: D
Rationale: Insomnia and appetite suppression are common methylphenidate side effects.
A good history of herb and supplement use is critical before prescribing because approximately % of patients in the United States are using herbal products.
- A. 10
- B. 5
- C. 38
- D. 70
Correct Answer: C
Rationale: Approximately 38% of U.S. patients use herbal products, necessitating a thorough history.
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