Nokea
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
- A. Selective estrogen receptor modulators
- B. Aspirin
- C. Glucocorticoids
- D. Calcium supplements
Correct Answer: C
Rationale: Glucocorticoids cause bone loss, warranting bisphosphonate prophylaxis; SERMs protect bone.
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What concept is considered when generic drugs are substituted for brand name drugs?
- A. Bioavailability
- B. Critical concentration
- C. Distribution
- D. Half-life
Correct Answer: A
Rationale: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand name drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a generic drug substitution. Critical concentration is the amount of a drug that is needed to cause a therapeutic effect and should not differ between generic and brand name medications. Distribution is the phase of pharmacokinetics, which involves the movement of a drug to the body's tissues and is the same in generic and brand name drugs. A drug's half-life is the time it takes for the amount of drug to decrease to half the peak level, which should not change when substituting a generic medication.
Which of the following is used for the treatment of primary hyperaldosteronism:
- A. Furosemide
- B. Hydrocortisone
- C. Spironolactone
- D. Dexamethasone
Correct Answer: C
Rationale: Spironolactone is an aldosterone antagonist, making it effective for treating primary hyperaldosteronism by blocking excess aldosterone effects.
When taken with aminoglycosides, platinum chemotherapy or cyclosporin increase the risk of
- A. Kidney damage
- B. Ototoxicity
Correct Answer: A
Rationale: Platinum chemotherapy (e.g., cisplatin) and cyclosporin both potentiate aminoglycoside nephrotoxicity, increasing kidney damage risk.
A 49-year-old woman with a history of hypertension is treated with spironolactone. She has good blood pressure control and in the last 6 months has shown an improvement in her hirsutism. What is the most likely explanation for these findings?
- A. Androgen receptor inhibition of the hair follicle
- B. Drug toxicity
- C. Hypoaldosteronism
- D. Testosterone levels are elevated
Correct Answer: A
Rationale: Spironolactone's anti-androgenic effects inhibit androgen receptors, reducing hirsutism, alongside its aldosterone antagonism for hypertension.
Newborns are at risk for early vitamin K deficiency bleeding and the American Academy of Pediatrics recommends that all newborns receive:
- A. IM vitamin K (phytonadione) within 24 hours of birth
- B. Oral vitamin K supplementation in the first 3 weeks of life
- C. Formula containing vitamin K or breast milk
- D. Oral vitamin K in the first 24 hours after birth
Correct Answer: A
Rationale: IM vitamin K is standard to prevent vitamin K deficiency bleeding in newborns.