Nokea
Drugs that may interact with vaccines include:
- A. Immunosuppressants
- B. Antibiotics
- C. Antihistamines
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because immunosuppressants (e.g., prednisone) reduce vaccine efficacy by weakening immune response, per CDC guidelines. Choice B is incorrect as antibiotics don't typically affect vaccines. Choice C is wrong because antihistamines lack vaccine interactions. Choice D is incorrect since only immunosuppressants apply.
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Upregulation or hypersensitization may lead to:
- A. Increased response to a drug
- B. Decreased response to a drug
- C. An exaggerated response if the drug is withdrawn
- D. Refractoriness or complete lack of response
Correct Answer: C
Rationale: Choice C is correct because upregulation (more receptors) or hypersensitization from chronic antagonist use can cause an exaggerated rebound response if withdrawn, as seen with beta blockers. Choice A is incorrect as increased response occurs during use, not withdrawal. Choice B is wrong because decreased response isn't typical of upregulation. Choice D is incorrect since refractoriness relates to agonists, not this scenario.
Drugs that require refrigeration include:
- A. Insulin
- B. Amoxicillin suspension
- C. Vaccines
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because insulin (protein stability), amoxicillin suspension (post-reconstitution), and vaccines (biological potency) require refrigeration to maintain efficacy, per storage guidelines. Choice A is incorrect alone as it's one drug. Choice B is wrong by itself because amoxicillin is just part. Choice C is incorrect solo since vaccines are only one group.
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.
An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:
- A. Upregulate the total number of receptors
- B. Block the receptor with a partial agonist
- C. Alter the drug's metabolism
- D. Downregulate the numbers of that specific receptor
Correct Answer: D
Rationale: Choice D is correct because frequent agonist use can cause the body to downregulate receptors, reducing sensitivity to overstimulation as a compensatory mechanism. Choice A is incorrect as upregulation occurs with antagonists, not agonists. Choice B is wrong because partial agonists compete, not result from frequent use. Choice C is incorrect since metabolism changes aren't the primary receptor response.
A patient is taking drug A and drug B. The primary care NP notes increased effects of drug B. The NP should suspect that in this case drug A is a cytochrome P450 (CYP450) enzyme:
- A. inhibitor.
- B. substrate.
- C. inducer.
- D. metabolizer.
Correct Answer: A
Rationale: The correct answer is A because a CYP450 inhibitor (drug A) reduces metabolism of drug B, increasing its effects. Choice B is incorrect as a substrate is acted upon, not inhibiting. Choice C is wrong since an inducer increases metabolism, reducing effects. Choice D is inaccurate as 'metabolizer' isn’t a CYP450 role.