Nokea
Rifampin is a nonspecific CYP450 inducer that may:
- A. Lead to toxic levels of rifampin and must be monitored closely
- B. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
- C. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
- D. Cause nonspecific changes in drug metabolism
Correct Answer: C
Rationale: Rifampin induces CYP450, speeding metabolism of drugs like oral contraceptives , reducing efficacy, not causing toxicity or nonspecificity .
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Corticosteroids are acting on:
- A. Ion channels
- B. Thirosinkinase
- C. G-proteins
- D. genome and cases gene transcription
Correct Answer: D
Rationale: Corticosteroids act on the genome, binding to receptors that regulate gene transcription.
The U.S. Food and Drug Administration regulates:
- A. Prescribing of drugs by MDs and NPs
- B. The official labeling for all prescription and over-the-counter drugs
- C. Off-label recommendations for prescribing
- D. Pharmaceutical educational offerings
Correct Answer: B
Rationale: The FDA regulates drug labeling , not prescribing practices , off-label use , or education , which fall under state or professional domains.
The nurse is preparing to administer an intravenous polymyxin antibiotic. The patient reports dizziness along with numbness and tingling of the hands and feet. The nurse will perform which action?
- A. Administer the drug since these are harmless side effects
- B. Hold the drug and notify the provider of these adverse reactions
- C. Obtain an order for an oral form of this medication
- D. Request an order for serum electrolytes
Correct Answer: B
Rationale: Polymyxin neurotoxicity (dizziness, numbness) warrants holding and reporting; these aren't harmless , and it's not oral . Polymyxins can cause nephrotoxicity and neurotoxicity.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
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 glucocorticoid synthesis by blocking adrenal steroidogenesis, useful in Cushing's syndrome management.