Nokea
Which of the following agents is an alfa1 alfa2 beta1 beta2 receptor agonist?
- A. Methoxamine
- B. Albuterol
- C. Epinephrine
- D. Norepinephrine
Correct Answer: C
Rationale: The correct answer is C: Epinephrine. Epinephrine is an alpha1, alpha2, beta1, and beta2 receptor agonist. It acts on all four types of adrenergic receptors, making it unique among the choices. Methoxamine is a selective alpha1 agonist (A). Albuterol is a beta2 agonist (B). Norepinephrine is an alpha1, alpha2, and beta1 agonist, but not a beta2 agonist (D). Therefore, only epinephrine fits the criteria of being an alpha1, alpha2, beta1, and beta2 receptor agonist.
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Ramelteon (Rozerem) is prescribed for a patient with insomnia. The nurse checks the patient’s medical history, knowing that this medication is contraindicated in which disorder?
- A. Coronary artery disease
- B. Renal insufficiency
- C. Liver disease
- D. Anemia
Correct Answer: C
Rationale: The correct answer is C: Liver disease. Ramelteon is metabolized in the liver, so patients with liver disease may have impaired drug metabolism, leading to potential toxicity. Coronary artery disease (A), renal insufficiency (B), and anemia (D) are not contraindications for ramelteon as they do not directly affect drug metabolism in the liver.
The state of “general anesthesia” usually includes:
- A. Analgesia
- B. Loss of consciousness inhibition of sensory and autonomic reflexes
- C. Amnesia
- D. All of the above
Correct Answer: D
Rationale: Step 1: General anesthesia involves analgesia to block pain signals.
Step 2: It causes loss of consciousness by inhibiting sensory and autonomic reflexes.
Step 3: It induces amnesia to prevent memory formation during the procedure.
Step 4: Therefore, all the elements - analgesia, loss of consciousness, and amnesia - are essential components of general anesthesia, making choice D the correct answer. Other choices are incorrect because they individually do not cover all the necessary aspects of general anesthesia.
This drug is a Class IC antiarrhythmic drug:
- A. Flecainide
- B. Sotalol
- C. Lidocaine
- D. Verapamil
Correct Answer: A
Rationale: Rationale:
1. Flecainide is classified as a Class IC antiarrhythmic drug based on Vaughan Williams classification.
2. Class IC drugs block sodium channels in cardiac tissue, slowing conduction.
3. Flecainide is used to treat ventricular arrhythmias.
4. Sotalol (Class III), Lidocaine (Class IB), and Verapamil (Class IV) belong to different antiarrhythmic classes.
Summary:
Sotalol is a Class III antiarrhythmic drug that blocks potassium channels. Lidocaine is a Class IB drug that blocks sodium channels. Verapamil is a Class IV drug that blocks calcium channels. These drugs have different mechanisms of action compared to Class IC drugs like Flecainide.
Which of the following would be a useful drug to add to the patient's therapeutic regimen?
- A. Metoprolol
- B. Digoxin
- C. Dobutamine
- D. Milrinone
Correct Answer: A
Rationale: The correct answer is A: Metoprolol. Metoprolol is a beta-blocker commonly used in heart failure to reduce morbidity and mortality. It improves symptoms, decreases hospitalizations, and increases survival rates in heart failure patients. It works by blocking the effects of adrenaline on the heart, leading to decreased heart rate and blood pressure, which reduces the workload on the heart. Choice B, Digoxin, is not typically used as a first-line treatment in heart failure. Choice C, Dobutamine, is a short-acting inotrope used in acute heart failure exacerbations, not for long-term therapy. Choice D, Milrinone, is a phosphodiesterase inhibitor used in acute heart failure, but it has more side effects and is not recommended for long-term use.
A ganglioblocking drug for hypertension treatment is:
- A. Hydralazine
- B. Tubocurarine
- C. Trimethaphan
- D. Metoprolol
Correct Answer: C
Rationale: The correct answer is C: Trimethaphan. Trimethaphan is a ganglioblocking drug that acts on the autonomic nervous system by blocking nicotinic receptors in ganglia, reducing sympathetic outflow and lowering blood pressure. Hydralazine (A) is a direct vasodilator, Tubocurarine (B) is a neuromuscular blocker, and Metoprolol (D) is a beta blocker. These drugs do not act specifically on ganglia to lower blood pressure like Trimethaphan does.