Beta blockers are prescribed for diabetics with caution because of their ability to produce hypoglycemia and block the common symptoms of it. Which of the following symptoms of hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible decreased blood glucose?
- A. Dizziness
- B. Increased heart rate
- C. Nervousness and shakiness
- D. Diaphoresis
Correct Answer: D
Rationale: Diaphoresis (sweating) is not blocked by beta blockers and signals hypoglycemia.
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Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Hallucinations
- B. Increased salivation
- C. Diarrhea
- D. Discoloration of urine
Correct Answer: A
Rationale: Pramipexole, a dopamine agonist, can cause hallucinations , especially in Parkinson's patients.
A 24-year-old female is prescribed erythromycin for gastroparesis. It is prescribed four times daily due to its short half-life. What is the rationale for such a frequent dosing?
- A. Achieve the steady-state plasma concentration of the drug
- B. Aid more complete distribution of the drug
- C. Avoid the toxicity of the drug because of its low therapeutic index
- D. Ensure that the drug concentration remains constant over time
Correct Answer: C
Rationale: Frequent dosing is required due to erythromycin's short half-life and low therapeutic index, which means a narrow margin between effective and toxic doses, necessitating careful maintenance to avoid toxicity.
The types of antagonism are:
- A. Summarized
- B. Potentiated
- C. Additive
- D. Competitive
Correct Answer: D
Rationale: Competitive antagonism is a recognized type, involving receptor competition between agonist and antagonist.
The patient tells the nurse about a new drug being tested to treat the disease she was diagnosed with and asks the nurse whether the doctor can prescribe a medication still in the preclinical phase of testing. What is the nurses best response?
- A. The doctor would have to complete a great deal of paperwork to get approval to prescribe that drug.
- B. Sometimes pharmaceutical companies are looking for volunteers to test a new drug and the doctor could give them your name.
- C. Drugs in the preclinical phase of testing are only tested on animals and so would not be available to you.
- D. Drugs in the preclinical phase of testing are given only to healthy young men and so would not be available to you.
Correct Answer: C
Rationale: During the preclinical phase of testing drugs are tested on animals and are not available to patients. In phase I, the drug is tested on volunteers who are usually healthy young men. It is only in phase III studies that the drug is made available to prescribers who agree to closely monitor patients getting the medication.
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