Nokea
Phenylephrine is useful for all of the following except
- A. Anaphylactic shock
- B. Mydriasis
- C. Nasal decongestant
- D. Artial tachycardia
Correct Answer: A
Rationale: Phenylephrine (alpha-agonist) is not used in anaphylactic shock (epinephrine is preferred).
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A 66-year-old man is admitted to the hospital with confusion, nausea, and blurred vision. He is currently on digoxin for the treatment of heart failure. On physical exam, his heart rate is 120 bpm. Further evaluation reveals a digoxin level of 5.3 ng/mL (normal range: 0.5-2 ng/mL). The doctor believes his symptoms are due to digoxin toxicity. Which parameter is used to indicate the ability of digoxin to produce the desired effect relative to a toxic effect?
- A. Bioavailability
- B. Efficacy
- C. Intrinsic activity
- D. Therapeutic index
Correct Answer: D
Rationale: Therapeutic index (TI) measures the relative safety of a drug by comparing the dose required for a therapeutic effect to the dose that produces toxicity. In this case, digoxin toxicity is indicated by the elevated level, and TI is the relevant parameter.
A non-competitive antagonist :
- A. Alters the mechanism of action of an agonist
- B. Alters the potency of an agonist
- C. Shifts the dose-response curve of an agonist to the right
- D. Decreases the maximum response to an agonist
Correct Answer: D
Rationale: Non-competitive antagonists reduce the maximal response (efficacy), not potency, distinguishing them from competitive antagonists.
When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added to the treatment regimen to control blood glucose and limit complication risks. Which of the following statements is accurate based on research?
- A. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia
- B. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain than the oral antidiabetic agents
- C. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-acting insulins
- D. Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral protamine Hagedorn insulin added at bedtime
Correct Answer: D
Rationale: NPH at bedtime targets postprandial hyperglycemia in type 2 diabetes; premixed insulins vary in efficacy.
Which drug reference contains monographs about virtually every single-entity drug available in the United States and describes therapeutic uses of drugs, including approved and unapproved uses?
- A. Martindale: The Complete Drug Reference
- B. AHFS Drug Information
- C. Drug Reference
- D. Drug Facts and Comparisons
Correct Answer: B
Rationale: AHFS Drug Information contains monographs about virtually every single-entity drug available in the United States and describes therapeutic uses of drugs, including approved and unapproved uses.
Which of the following diagnostic studies would NOT indicate a problem related to a reductase inhibitor?
- A. Elevated serum transaminase
- B. Increased serum creatinine
- C. Elevated creatinine kinase
- D. Increased white blood cell counts
Correct Answer: D
Rationale: WBC elevation is unrelated to reductase inhibitors; others indicate liver, kidney, or muscle issues.