Nokea
Upregulation or hypersensitization may lead to:
- A. Increased response to a drug
- B. Decreased response to a drug
- C. An exaggerated response if the drug is withdrawn
- D. Refractoriness or complete lack of response
Correct Answer: C
Rationale: Choice C is correct because upregulation (more receptors) or hypersensitization from chronic antagonist use can cause an exaggerated rebound response if withdrawn, as seen with beta blockers. Choice A is incorrect as increased response occurs during use, not withdrawal. Choice B is wrong because decreased response isn't typical of upregulation. Choice D is incorrect since refractoriness relates to agonists, not this scenario.
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Drugs that are Pregnancy Category C:
- A. Have known fetal risks that outweigh the benefits
- B. Have no adequate studies in pregnant women
- C. Are proven safe in pregnancy
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because Category C drugs lack sufficient human studies, with animal studies showing risk or no data, used only if benefits justify, per FDA. Choice A is incorrect as that defines Category X, not C. Choice C is wrong because Category B, not C, indicates safety. Choice D is incorrect since only B fits Category C.
The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
- A. Minimum adverse effect level
- B. Peak of action
- C. Onset of action
- D. Therapeutic range
Correct Answer: C
Rationale: Choice C is correct because the onset of action is when a drug first shows a therapeutic effect on the concentration curve, marking the start of its clinical impact. Choice A is incorrect as ‘minimum adverse effect level' isn't a standard term; it confuses with toxicity thresholds. Choice B is wrong because peak of action is the maximum effect, not the first sign. Choice D is incorrect since therapeutic range is the concentration window for efficacy, not a specific time point.
An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: A
Rationale: Choice A is correct because orthostatic hypotension can occur with a first dose of drugs like antihypertensives, subsiding as the body adjusts, a classic first-dose reaction. Choice B is incorrect as purple glove syndrome is a rare phenytoin effect, not first-dose specific. Choice C is wrong because hemolytic anemia is a type II reaction, not first-dose. Choice D is incorrect since contact dermatitis is a delayed, not first-dose, reaction.
Strategies to improve adherence to medication regimes include:
- A. Assuming that the patient understands the directions on the prescription bottle
- B. Using pictograms or illustrations to explain how to take the medication
- C. Assuming that the patient's health literacy level is the same as their general literacy
- D. Using the patient's preferred language when there is a language barrier
Correct Answer: B
Rationale: Choice B is correct because pictograms clarify instructions visually, aiding comprehension and adherence, especially for low-literacy patients. Choice A is incorrect as assuming understanding can lead to errors. Choice C is wrong because health literacy varies from general literacy, needing specific attention. Choice D is incorrect here as it's a good strategy but not listed in this question's options correctly—B fits best.
Passive monitoring of drug effectiveness includes:
- A. Therapeutic drug levels
- B. Adding or subtracting medications from the treatment regimen
- C. Ongoing provider visits
- D. Instructing the patient to report if the drug is not effective
Correct Answer: D
Rationale: Choice D is correct because passive monitoring relies on patient feedback, like reporting ineffectiveness, rather than active measures like lab tests. Choice A is incorrect as therapeutic levels are active monitoring. Choice B is wrong because adjusting medications is an intervention, not monitoring. Choice C is incorrect since provider visits are active engagement, not passive.