Nokea
Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it:
- A. Decreases the amount of calcium inside the cell
- B. Reduces stroke volume
- C. Increases the activity of the Na+/K+/ATPase pump indirectly
- D. Decreases heart rate
Correct Answer: A
Rationale: Calcium channel blockers reduce intracellular calcium, relaxing vascular smooth muscle.
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Under the influence of thyroxin, cholesterol level in the blood:
- A. Increase
- B. Decrease
- C. Does not change
Correct Answer: B
Rationale: Thyroxine lowers cholesterol by increasing its metabolism and excretion.
The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the site for the metabolism of most drugs?
- A. Liver
- B. Lungs
- C. Kidneys
- D. Intestinal mucosa
Correct Answer: A
Rationale: Although the kidneys, lungs, plasma, and intestinal mucosa may aid in the metabolism of drugs, most drugs are metabolized by the liver.
The adverse events of biguanides are:
- A. Alkalosis
- B. Hypoxemia/acidosis
- C. Weight loss
- D. Anemia
Correct Answer: B
Rationale: Biguanides like metformin can cause lactic acidosis, a serious adverse effect related to impaired mitochondrial function.
A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.