Nokea
Drugs that are Pregnancy Category C:
- A. Have known fetal risks that outweigh the benefits
- B. Have no adequate studies in pregnant women
- C. Are proven safe in pregnancy
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because Category C drugs lack sufficient human studies, with animal studies showing risk or no data, used only if benefits justify, per FDA. Choice A is incorrect as that defines Category X, not C. Choice C is wrong because Category B, not C, indicates safety. Choice D is incorrect since only B fits Category C.
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Drugs that are affected by genetic polymorphisms of UGT1A1 include:
- A. Warfarin
- B. Irinotecan
- C. Acetaminophen
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because irinotecan's active metabolite is glucuronidated by UGT1A1; poor function increases toxicity, requiring genetic consideration. Choice A is incorrect as warfarin's metabolism is via CYP2C9, not UGT1A1. Choice C is wrong because acetaminophen uses other UGT enzymes, not specifically UGT1A1 critically. Choice D is incorrect since only irinotecan is notably affected by UGT1A1 polymorphisms.
Over-the-counter drugs that should be avoided in patients with hypertension include:
- A. Acetaminophen
- B. Pseudoephedrine
- C. Ibuprofen
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because pseudoephedrine, a decongestant, raises blood pressure via vasoconstriction, risky in hypertension, per guidelines. Choice A is incorrect as acetaminophen doesn't affect BP. Choice C is wrong because ibuprofen's BP effect is milder and not absolute avoidance. Choice D is incorrect since only pseudoephedrine is key.
The elderly are at high risk of ADRs due to:
- A. Having greater muscle mass than younger adults, leading to higher volume of distribution
- B. The extensive studies that have been conducted on drug safety in this age group
- C. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect
- D. Age-related decrease in renal function
Correct Answer: D
Rationale: Choice D is correct because an age-related decline in renal function slows drug excretion, increasing ADR risk as drugs accumulate. Choice A is incorrect as muscle mass decreases with age, not increases. Choice B is wrong because studies are often limited in the elderly, not extensive. Choice C is incorrect since the blood-brain barrier's permeability doesn't typically lessen, and higher doses aren't standard.
Clinical judgment in prescribing includes:
- A. Factoring in the cost to the patient of the medication prescribed
- B. Always prescribing the newest medication available for the disease process
- C. Handing out drug samples to poor patients
- D. Prescribing all generic medications to cut costs
Correct Answer: S
Rationale: Choice A is correct because clinical judgment involves balancing efficacy, safety, and cost to ensure patients can afford and adhere to treatment, which is critical for successful outcomes. Choice B is incorrect as always choosing the newest medication ignores evidence-based practice; newer drugs may lack long-term data or be unnecessarily expensive. Choice C is wrong because distributing samples isn't a sustainable prescribing strategy and may not meet ongoing needs. Choice D is also incorrect since mandating generics could compromise efficacy if a brand-name drug is clinically necessary.
Resources for patients with drug abuse issues include:
- A. Substance Abuse and Mental Health Services Administration (SAMHSA)
- B. National Institute on Drug Abuse (NIDA)
- C. Local support groups
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because SAMHSA (helpline), NIDA (research/support), and local groups (e.g., AA) provide comprehensive resources for drug abuse, per national frameworks. Choice A is incorrect alone as it's one resource. Choice B is wrong by itself because NIDA is just part. Choice C is incorrect solo since groups are only one option.