Nokea
When melatonin is used to induce sleep, the recommendation is that the patient:
- A. Take 10 mg 30 minutes before bed nightly
- B. Take 1 to 5 mg 30 minutes before bed nightly
- C. Not take melatonin more than three nights a week
- D. Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Correct Answer: B
Rationale: 1-5 mg of melatonin 30 minutes before bed is the recommended dose for sleep induction.
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Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes:
- A. Gout may worsen with therapy
- B. Febuxostat may cause severe diarrhea
- C. He should consume a high-calcium diet
- D. He will need frequent CBC monitoring
Correct Answer: A
Rationale: Febuxostat can initially worsen gout as uric acid mobilizes; diarrhea or calcium aren't emphasized.
Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs):
- A. A 32-year-old male
- B. A 22-year-old female
- C. A 3-month-old female
- D. A 48-year-old male
Correct Answer: C
Rationale: Infants like a 3-month-old have immature organ systems, increasing ADR risk compared to healthy adults.
Jim is having a hip replacement surgery and would like to self-donate blood for the surgery. In addition to being prescribed epogen alpha he should also be prescribed:
- A. Folic acid to prevent megaloblastic anemia
- B. Iron, to start when the epogen starts
- C. An antihypertensive to counter the adverse effects of epogen
- D. Vitamin B12 to prevent pernicious anemia
Correct Answer: B
Rationale: Iron supports erythropoiesis with epoetin alfa; antihypertensives manage side effects, not prophylaxis.
Persistent dry cough is a common side effect of:
- A. ACE inhibitor
- B. Calcium channel blockers
- C. Beta blockers
- D. Angiotensin receptor blockers
Correct Answer: A
Rationale: ACE inhibitors, such as lisinopril, frequently cause a persistent dry cough due to increased bradykinin levels irritating the respiratory tract.
Administration of sulfonamide may intensify the action of tolbutamide, through:
- A. Activation of the islets of pancreas
- B. Direct action on the utilization of glucose
- C. Synergistic action
- D. Competing with tolbutamide in plasma protein binding
Correct Answer: D
Rationale: Sulfonamides displace tolbutamide from plasma proteins, increasing free drug levels and enhancing its hypoglycemic effect.