Nokea
Choose an antihypertensive agent that is most likely to produce tachycardia, fluid retention and hirsutism?
- A. Captopril
- B. Guanethidine
- C. Minoxidil
- D. Prazosin
Correct Answer: C
Rationale: Minoxidil causes reflex tachycardia, fluid retention, and hirsutism.
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Several processes enable a drug to reach a specific concentration in the body. Together they are called dynamic equilibrium. What are these processes? (Select one that does not apply.)
- A. Distribution to the active site
- B. Biotransformation
- C. Absorption from the muscle
- D. Excretion
Correct Answer: C
Rationale: The actual concentration that a drug reaches in the body results from a dynamic equilibrium involving several processes: Absorption from the site of entry (can be from the muscle, the gastrointestinal (GI) tract if taken orally, of the subcutaneous tissue if given by that route); Distribution to the active site; biotransformation (metabolism) in the liver; excretion from the body. Interaction with other drugs is not part of the dynamic equilibrium.
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having 'strange' thoughts. The appropriate initial action would be:
- A. Increase her dose
- B. Assess for suicidal ideation
- C. Discontinue the medication immediately
- D. Decrease her dose to half then slowly titrate up the dose
Correct Answer: B
Rationale: Gabapentin can cause mood changes; assessing for suicidal ideation is the priority.
Which statement is true about over-the-counter (OTC) drugs?
- A. They are not listed in the USP NF
- B. A prescription from a healthcare provider is needed
- C. They are sold without a prescription
- D. They are known only by their brand names
Correct Answer: C
Rationale: OTC medications do not require a prescription and are sold freely, listed in the USP NF, and known by both generic and brand names.
Which route of drug administration is most likely to lead to first pass effect?
- A. Sublingual
- B. Oral
- C. Intravenous
- D. Intramuscular
Correct Answer: B
Rationale: Oral administration subjects drugs to the first-pass effect, where they are metabolized by the liver via the portal vein before reaching systemic circulation, reducing bioavailability.
Many patients with hyperlipidemia are treated with more than one drug. Combining a fibric acid derivative such as gemfibrozil with which of the following is not recommended? The drug and the reason must both be correct for the answer to be correct.
- A. Reductase inhibitors, due to an increased risk for rhabdomyolysis
- B. Bile-acid sequestering resins, due to interference with folic acid absorption
- C. Grapefruit juice, due to interference with metabolism
- D. Niacin, due to decreased gemfibrozil activity
Correct Answer: A
Rationale: Gemfibrozil with statins increases rhabdomyolysis risk.