Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
- A. May lead to toxicity if taken with aspirin
- B. Is contraindicated in children with flu-like illness
- C. Has antimicrobial effects against bacterial and viral enteropathogens
- D. All of the above
Correct Answer: D
Rationale: All apply: bismuth with aspirin risks salicylate toxicity , is contraindicated in kids with flu (B, Reye's syndrome), and has antimicrobial action .
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As a clinical consultant for the Breathright drug research firm, you are given the task of using an in vitro assay to screen ten thousand drug analogs to find the most potent beta-2 receptor agonist. When analysing your data, the biomarker that you should screen for is:
- A. E max
- B. Emax
- C. EC50
- D. Half life
Correct Answer: C
Rationale: Potency is measured by EC50 (dose producing 50% of max effect); lower EC50 indicates higher potency.
Midazolam as compared to diazepam is:
- A. Less cerebroprotective
- B. More cerebroprotective
- C. Same as diazepam
- D. No cerebroprotective effect
Correct Answer: A
Rationale: Midazolam is less cerebroprotective than diazepam.
When melatonin is used to induce sleep, the recommendation is that the patient:
- A. Take 10 mg 30 minutes before bed nightly
- B. Take 1 to 5 mg 30 minutes before bed nightly
- C. Not take melatonin more than three nights a week
- D. Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Correct Answer: B
Rationale: 1-5 mg of melatonin 30 minutes before bed is the recommended dose for sleep induction.
What does the lipid solubility of the drug influence?
- A. Absorption of the drug
- B. Metabolism of the drug
- C. Excretion of the drug
- D. Distribution of the drug
Correct Answer: D
Rationale: Factors that can affect distribution include the drug's lipid solubility and ionization and the perfusion of the reactive tissue. The lipid solubility of a drug does not influence absorption, metabolism, or excretion.
While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following clients?
- A. A 48-year-old Caucasian male diagnosed with atrial fibrillation
- B. A 55-year-old African American female diagnosed with hypertension
- C. A 63-year-old Caucasian female diagnosed with sick sinus syndrome
- D. A 64-year-old African American male diagnosed with heart failure
Correct Answer: D
Rationale: BiDil (hydralazine/isosorbide) is FDA-approved specifically for heart failure in African Americans , showing improved outcomes in this population.