Nokea
The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
- A. A
- B. B
- C. C
- D. D
Correct Answer: B
Rationale: Type B reactions are idiosyncratic, unpredictable responses to normal doses, unlike dose-related Type A or chronic Type C/D.
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Daniel has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. It is time to discontinue the prednisone. How is prednisone discontinued?
- A. Patients with asthma are transitioned directly off the prednisone onto inhaled corticosteroids
- B. Prednisone can be abruptly discontinued with no adverse effects
- C. Develop a tapering schedule to slowly wean Daniel off the prednisone
- D. Substitute the prednisone with another anti-inflammatory such as ibuprofen
Correct Answer: C
Rationale: Tapering prevents adrenal suppression after high-dose prednisone; abrupt stop risks crisis.
Where are large fenestrations or slit junctions located?
- A. Bone
- B. Brain
- C. Skin
- D. Liver
Correct Answer: D
Rationale: The liver has large fenestrations in sinusoidal endothelium, allowing easy drug passage, unlike the brain (tight junctions) or bone/skin (less permeable).
A patient on a Class IV antiarrhythmic is experiencing bradycardia. Which medication is the patient most likely taking?
- A. Amiodarone
- B. Diltiazem
- C. Flecainide
- D. Lidocaine
Correct Answer: B
Rationale: Diltiazem, a Class IV calcium channel blocker, slows AV node conduction, commonly causing bradycardia.
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.
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.