Nokea
Most common indication for therapeutic monitoring of plasma levels of a drug is
- A. Hit & run drugs
- B. Drugs with irreversible action
- C. Narrow therapeutic range
- D. Failure of response
Correct Answer: C
Rationale: Drugs with a narrow therapeutic range (e.g., digoxin) require monitoring to avoid toxicity.
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The following drug is used for diabetic coma:
- A. Glibenclamid
- B. Long acting insulin preparations
- C. The rapid and intermediate acting insulin preparations
- D. Metformin
Correct Answer: C
Rationale: Rapid and intermediate-acting insulins are used to quickly correct hyperglycemia in diabetic coma.
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.
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.
A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan). The nurse will expect to monitor which lab values in this patient?
- A. Blood urea nitrogen (BUN) and creatinine
- B. Electrolytes
- C. Fluconazole levels
- D. Glucose
Correct Answer: D
Rationale: Fluconazole inhibits CYP450, increasing sulfonylurea levels and hypoglycemia risk; glucose monitoring is key. Patients taking sulfonylurea drugs may have altered serum glucose when taking antifungal medications.
Glucocorticoids enhance:
- A. Inhibition of phospholipase A2 in leukocytes with stimulation of annexin synthesis
- B. Decrease of thrombocyte activating factor via inhibition of 5 lipooxigenase
- C. Inhibition of leukotriene synthesis and decrease of lyso-glycerilphosphorilcholine production
- D. inhibition of prostaglandin synthesis via blocking 12 lypooxigenase
Correct Answer: A
Rationale: Glucocorticoids inhibit phospholipase A2, reducing inflammatory mediators by stimulating annexin (lipocortin) synthesis.