Nokea
Drug of choice in phenothiazine induced parkinsonism is
- A. Levodopa
- B. Haloperidol
- C. Metoclopramide
- D. None of the above
Correct Answer: A
Rationale: Levodopa counters phenothiazine-induced parkinsonism.
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Not metabolized in liver
- A. Cimetidine
- B. Phenytoin
- C. Diazepam
- D. Penicillin G
Correct Answer: D
Rationale: Penicillin G is primarily excreted unchanged by the kidneys, unlike the others metabolized by the liver.
Research has shown that when patients who are covered by Medicare Part D reach the 'donut hole' in coverage they:
- A. Ask for extra refills of medication to get them through the months of no coverage
- B. Fill their prescriptions less frequently, including critical medications such as warfarin or a statin
- C. Fill their critical medications, but hold off on filling less-critical medications
- D. Demonstrate no change in their prescription filling pattern
Correct Answer: B
Rationale: Patients reduce prescription filling, even for critical drugs, during the donut hole.
A patient who has a long history of alcohol abuse is admitted to the hospital for detoxification. In addition to medications needed to treat withdrawal symptoms, the nurse will anticipate giving intravenous
- A. dopamine to restore blood pressure
- B. fluid boluses to treat dehydration
- C. glucose to prevent hypoglycemia
- D. thiamine to treat nutritional deficiency
Correct Answer: D
Rationale: Thiamine prevents Wernicke's encephalopathy in alcohol detox; glucose follows if needed. Thiamine should be given to prevent Wernicke's encephalopathy in patients treated for alcoholism.
The nurse learns that a drug needed by the patient is classified as an orphan drug and recognizes what as a reason for this classification? (Select one that does not apply.)
- A. The drug is rarely prescribed.
- B. The drug has dangerous adverse effects.
- C. The drug treats a rare disease.
- D. The patent on the medication is still effective.
Correct Answer: D
Rationale: Drugs are classified as orphan drugs when they are not financially viable for a drug company to produce either because of risk for lawsuits about adverse effects or because the drug is not prescribed, which is often seen in rare diagnoses. Generic drugs are not produced until the patent expires, but this has no impact on classifying a particular drug as an orphan drug. Generic drugs are often produced by companies that only manufacture drugs without conducting research, but this has no bearing on the classification of orphan drugs.
A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this is due to:
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.