Nokea
Candesartan and irbesartan are angiotensin receptor blockers that are used to treat hypertension. The therapeutic dose range for candesartan is 4 to 32 mg, as compared to 75 to 300 mg for irbesartan. which of the following regarding this statement is correct?
- A. Candesartan is more potent than is irbesartan
- B. Candesartan and irbesartan have different efficacy
- C. Candesartan is a non competitive antagonist for irbesartan
- D. Irbesartan is a competitive antagonist for candesartan
Correct Answer: A
Rationale: Lower dose range for candesartan indicates higher potency (lower EC50) compared to irbesartan.
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Which of the following sign/symptom would NOT be expected from organophosphate poisoning?
- A. Dry skin and mucous membranes
- B. Increased salivation
- C. Increased bowel sounds
- D. Urinary urgency
Correct Answer: A
Rationale: Organophosphates cause wet symptoms (salivation, etc.); dry skin is typical of anticholinergics.
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
- A. Extend the dosage interval.
- B. Decrease the dose by 75%.
- C. Take no action because this value is expected in the older adult.
- D. Schedule a serum creatinine level to validate the CrCl value.
Correct Answer: A
Rationale: Reduced renal clearance (CrCl 25 ml/min) requires extending the dosage interval for nadolol.
Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:
- A. Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case
- B. Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness
- C. Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission
- D. Draw anticoagulation studies to make sure she does not have dangerously high bleeding times
Correct Answer: B
Rationale: Warfarin's delayed onset requires heparin overlap for immediate anticoagulation; this is standard, not an error or exception .
Identify potential drug-drug interactions that may occur with tamoxifen
- A. Not provided in document
- B. Not provided in document
- C. Not provided in document
- D. Not provided in document
Correct Answer: D
Rationale: This question lacks options in the document, but based on the answer key (ANS: 4), it is assumed to correspond to the fourth choice if options were present. Tamoxifen has significant interactions with CYP2D6 inhibitors (e.g., SSRIs), which can reduce its efficacy.
What is a prodrug
- A. Drag which increases efficiency of another drug
- B. Metabolic end product
- C. Inactive drag which gets activated in the body
- D. Drag which competes with another for metabolism
Correct Answer: C
Rationale: A prodrug is inactive until metabolized into an active form in the body.