Nokea
Binding of drugs to albumin is irreversible.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: False; binding to albumin is reversible, allowing drugs to dissociate and become active or available for elimination.
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Zero order kinetics are seen in all except
- A. Salicylate
- B. Atenolol
- C. Barbiturates
- D. Ethanol
Correct Answer: C
Rationale: Barbiturates typically follow first-order kinetics; others exhibit zero-order at high doses.
The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?
- A. Distribution
- B. First-pass effect
- C. Reduced absorption
- D. Gastrointestinal circulation
Correct Answer: B
Rationale: Drugs that are taken orally are usually absorbed from the small intestine directly into the portal venous system and then delivers these absorbed molecules into the liver, which immediately break the drug into metabolites, some of which are active and cause effects in the body, and some of which are deactivated and can be readily excreted from the body. As a result, a large percentage of the oral dose is destroyed at this point and never reaches the tissues. This process is not caused by distribution, absorption, or gastrointestinal circulation.
To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should do all of the following EXCEPT:
- A. Take the dose at bedtime
- B. Sit up slowly and dangle their feet before standing
- C. Monitor their blood pressure and skip a dose if the pressure is less than 120/80
- D. Weigh daily and report weight gain of greater than 2 pounds in one day
Correct Answer: C
Rationale: Skipping doses based on blood pressure is not recommended; it risks uncontrolled hypertension.
59 old year female hospitalized in emergency department with confusion and breathlessness. Physical examination reveals: tachycardia, tachypnea and disorientation. Patient has diabetes type 2 and remember that she has taken a drug in the morning. Which of the following can cause the above mentioned symptoms:
- A. Acarbose
- B. Glipizide
- C. Glucagon
- D. Metformin
Correct Answer: B
Rationale: Glipizide can cause hypoglycemia leading to confusion, tachycardia, and breathlessness, especially if taken without food.
A 60-year-old man with Type 2 diabetes mellitus is treated with pioglitazone. Which of the following phrases summarizes best this drug's main mechanism of action?
- A. Blocks intestinal carbohydrate absorption
- B. Causes glycosuria (increased renal glucose excretion)
- C. Increases hepatic gluconeogenesis
- D. Increases target tissue sensitivity to insulin
Correct Answer: D
Rationale: Pioglitazone enhances insulin sensitivity in target tissues like muscle and fat via PPAR-gamma activation.