Pharmacology of Drugs Acting on Cardiovascular System

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An 18-year-old basketball player fell and twisted his ankle during a game. The nurse will expect to administer which type of analgesic?

  • A. Synthetic opioid, such as meperidine (Demerol)
  • B. Opium alkaloid, such as morphine sulfate
  • C. Opioid antagonist, such as naloxone HCL (Narcan)
  • D. Nonopioid analgesic, such as indomethacin (Indocin)
Correct Answer: D

Rationale: The correct answer is D: Nonopioid analgesic, such as indomethacin (Indocin). Given the ankle injury, nonopioid analgesics like indomethacin are appropriate for managing pain as they target inflammation and reduce pain without the risk of opioid-related side effects. Synthetic opioids (A) and opium alkaloids (B) are not typically indicated for mild to moderate pain like an ankle twist. Opioid antagonists (C) like naloxone are used to reverse opioid overdose, not for pain relief. In this case, the nonopioid analgesic is the most suitable choice for managing the player's pain effectively.

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A patient with bipolar disorder, mania, relapsed after discontinuing lithium. The health care provider prescribes lithium 600 mg BID and olanzapine (Zyprexa) 10 mg BID. What is the rationale for addition of olanzapine to the lithium regime? It will:

  • A. minimize the side effects of lithium.
  • B. bring hyperactivity under rapid control.
  • C. potentiate the antimanic action of lithium.
  • D. be used for long-term control of hyperactivity.
Correct Answer: B

Rationale: The correct answer is B: bring hyperactivity under rapid control. Olanzapine, an atypical antipsychotic, is commonly used in the acute treatment of mania due to its ability to rapidly control symptoms like hyperactivity. Lithium, on the other hand, is used for long-term mood stabilization in bipolar disorder. The addition of olanzapine helps address the acute manic symptoms while lithium works on the long-term management. Choices A and C are incorrect as olanzapine does not minimize lithium's side effects or potentiate its antimanic action. Choice D is incorrect as olanzapine is typically used for acute symptom management, not for long-term control of hyperactivity.

Indicate a muscarinic receptor-blocking drug:

  • A. Scopolamine
  • B. Pipecuronium
  • C. Trimethaphan
  • D. Pilocarpine
Correct Answer: A

Rationale: The correct answer is A: Scopolamine. Scopolamine is a muscarinic receptor-blocking drug that antagonizes the action of acetylcholine at muscarinic receptors. Scopolamine is commonly used for its anticholinergic effects, such as reducing salivation and mucous secretion.

B: Pipecuronium is a neuromuscular blocking agent that acts at the neuromuscular junction, not at muscarinic receptors.

C: Trimethaphan is a ganglionic blocker that acts at the autonomic ganglia, not at muscarinic receptors.

D: Pilocarpine is a muscarinic receptor agonist, not a muscarinic receptor blocker. It is used to stimulate muscarinic receptors for various therapeutic purposes.

Tick narcotic analgesic which is a phenylpiperidine derivative:

  • A. Codeine
  • B. Dezocine
  • C. Fentanyl
  • D. Buprenorphine
Correct Answer: C

Rationale: The correct answer is C: Fentanyl. Fentanyl is a phenylpiperidine derivative due to its specific chemical structure containing a piperidine ring attached to a phenyl group. Codeine (A) is an opioid, but not a phenylpiperidine derivative. Dezocine (B) is a benzomorphan derivative. Buprenorphine (D) is a thebaine derivative. Fentanyl stands out as the only option that fits the phenylpiperidine derivative category.

Withdrawal of which of the following drugs leads to rebound hypertension:

  • A. Prazosin
  • B. Hydralazine
  • C. Clonidine
  • D. Captopril
Correct Answer: C

Rationale: Clonidine, a central alpha-2 agonist, causes rebound hypertension on abrupt withdrawal due to sympathetic overactivity.

Major lipid class present in chylomicrons is

  • A. Endogenous triglycerides
  • B. Cholesterol esters
  • C. Dietary triglycerides
  • D. All of the above
Correct Answer: C

Rationale: Chylomicrons primarily transport dietary triglycerides absorbed from the intestine.