Nokea
Which of the following drugs most likely caused the adverse effect of dizziness and fainting when standing up rapidly?
- A. Propranolol
- B. Minoxidil
- C. Hydralazine
- D. Prazosin
Correct Answer: D
Rationale: The correct answer is D: Prazosin. Prazosin is an alpha-1 adrenergic blocker that can cause orthostatic hypotension, leading to dizziness and fainting when standing up rapidly. It works by dilating blood vessels, which can cause a sudden drop in blood pressure upon standing. Propranolol (A) is a beta-blocker and can cause dizziness but is less likely to cause orthostatic hypotension. Minoxidil (B) is a vasodilator that can cause rapid heart rate but not typically dizziness upon standing. Hydralazine (C) is a direct vasodilator that can cause reflex tachycardia but is less likely to cause orthostatic hypotension compared to alpha-1 blockers like Prazosin.
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Ramipril, an angiotensin-converting enzyme (ACE) inhibitor:
- A. Increases concentrations of angiotensin II
- B. Increases concentrations of bradykinin
- C. Increases noradrenaline release from sympathetic nerve terminals
- D. Increases aldosterone secretion
Correct Answer: B
Rationale: Ramipril reduces angiotensin II (A) by inhibiting ACE and increases bradykinin (B) by preventing its breakdown; it does not increase noradrenaline (C) or aldosterone (D) and causes hyperkalemia, not hypokalemia (E).
Mechanism of action of cyclosporine A is:
- A. Complement-mediated cytolysis of T lymphocytes
- B. ADCC towards T lymphocytes
- C. Inhibits calcineurin
- D. Compete for Fc receptors with autoantibodies
Correct Answer: C
Rationale: The correct answer is C: Inhibits calcineurin. Cyclosporine A works by inhibiting calcineurin, a protein phosphatase that is crucial for the activation of T cells. By blocking calcineurin, cyclosporine A prevents the production of interleukin-2, a key cytokine involved in T cell activation and proliferation. This ultimately leads to suppression of the immune response.
Choices A, B, and D are incorrect:
A: Complement-mediated cytolysis of T lymphocytes is not the mechanism of action of cyclosporine A.
B: ADCC towards T lymphocytes does not describe how cyclosporine A works.
D: Competing for Fc receptors with autoantibodies is not related to the mechanism of action of cyclosporine A.
A nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement would indicate a need for further follow-up instructions?
- A. “I will need scheduled blood work in order to monitor for toxic levels of this drug.”
- B. “I won’t stop taking this medication abruptly because there could be serious complications.”
- C. “I will not drink alcohol while taking this medication.”
- D. “I won’t take extra doses of this drug because I can become addicted.”
Correct Answer: A
Rationale: The correct answer is A because benzodiazepines do not typically require routine blood level monitoring. Monitoring for toxicity is generally done through clinical assessment rather than blood tests. Choice B is correct as abrupt withdrawal of benzodiazepines can lead to severe withdrawal symptoms. Choice C is correct as alcohol can enhance the sedative effects of benzodiazepines. Choice D is correct as benzodiazepines have a potential for addiction and should not be taken in higher doses than prescribed.
Barbiturates are being replaced by hypnotic benzodiazepines because of:
- A. Low therapeutic index
- B. Suppression in REM sleep
- C. High potential of physical dependence and abuse
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Barbiturates have a low therapeutic index, leading to a narrow range between therapeutic and toxic doses. They suppress REM sleep, which can lead to negative effects on sleep quality. Barbiturates also have a high potential for physical dependence and abuse, making them less desirable compared to benzodiazepines. Therefore, all the given reasons collectively contribute to the shift towards using hypnotic benzodiazepines over barbiturates.
Tick the group of antibiotics having an antimalarial effect:
- A. Aminoglycosides
- B. Tetracyclins
- C. Carbapenems
- D. Penicillins
Correct Answer: B
Rationale: Step 1: Tetracyclins are known to have antimalarial properties by inhibiting protein synthesis in Plasmodium species.
Step 2: Aminoglycosides (choice A) primarily target bacteria, not parasites like malaria.
Step 3: Carbapenems (choice C) and Penicillins (choice D) are both beta-lactam antibiotics that have no significant antimalarial effects.
Summary: Tetracyclins are the correct choice as they directly target malaria parasites, while the other options do not possess antimalarial properties.