Nokea
Which drug has a high first pass effect
- A. Amiodarone
- B. Phenytoin
- C. Verapamil
- D. Disopyramide
Correct Answer: C
Rationale: Verapamil undergoes extensive first-pass metabolism in the liver, reducing its bioavailability when taken orally.
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A nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)
- A. Cough
- B. Dizziness
- C. Increased libido
- D. Invention
Correct Answer: B
Rationale: Venlafaxine can cause dizziness , decreased libido , and hypotension ; 'invention' seems a typo.
Which of the following is an advantage of sublingual administration?
- A. Rapid absorption
- B. Convenient
- C. Avoid harsh GI environment
- D. Avoid first pass-metabolism
Correct Answer: D
Rationale: Sublingual administration offers rapid absorption , convenience , avoids the GI tract , and bypasses first-pass metabolism ; all are true, but D is a key pharmacological advantage.
What is correct concerning TI:
- A. A safer drug has a higher theraputic index
- B. TI might be equal to 1
- C. The more the unwanted adverse effect, the ration decreases
- D. You are in danger if you take 1.8 ng/ml of Digoxin which has the margin of safety (0.8-2)
Correct Answer: A
Rationale: A higher therapeutic index indicates a greater margin of safety between therapeutic and toxic doses, making the drug safer.
Monitoring of a patient on gabapentin to treat seizures includes:
- A. Routine therapeutic drug levels every 3 to 4 months
- B. Assessing for dermatologic reactions, including Steven's Johnson
- C. Routine serum electrolytes, especially in hot weather
- D. Recording seizure frequency, duration, and severity
Correct Answer: D
Rationale: Monitoring seizure activity is key to assessing gabapentin efficacy.
A competitive antagonist is a substance that:
- A. Interacts receptors and produces submaximal effect
- B. Binds to the same receptor site and progressively inhibits the agonist response
- C. Binds to the nonspecific sites of tissue
- D. Binds to one receptor subtype as an agonist and to another as an antagonist
Correct Answer: B
Rationale: Competitive antagonists compete for the same receptor site, reversibly inhibiting the agonist.