Nokea
Which of the following drugs used for gout decreases net renal tubular reabsorption of uric acid?
- A. Hypoxanthine
- B. Indomethacin
- C. Colchicine
- D. Allopurinol
Correct Answer: C
Rationale: Colchicine reduces inflammation but also decreases uric acid reabsorption indirectly.
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Which of the following statements is correct?
- A. Most drags are absorbed in ionized form
- B. Basic drags are generally bound to plasma albumin
- C. Microsomal enzymes are located in the mitochondria of hepatic cells
- D. Blood brain barrier is deficient at the chemo receptor trigger-zone
Correct Answer: D
Rationale: The chemoreceptor trigger zone has a deficient blood-brain barrier, allowing drug access; others are incorrect.
A drug which does not produce any action by itself but decreases the slope of the log dose-response curve and suppresses the maximal response to another drug is a...
- A. Physiological antagonist
- B. Competitive antagonist
- C. Noncompetitive antagonist
- D. Partial agonist
Correct Answer: C
Rationale: Noncompetitive antagonists reduce maximal response (efficacy) without shifting potency, matching the description.
An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
- A. Spending large amounts of money on medications
- B. Allergic reactions to medications
- C. Drug-drug interactions
- D. Critical concentrations of medications in the body
Correct Answer: C
Rationale: It is important that all health care providers have a complete list of the patient's medications to avoid drug-drug interactions caused by one provider ordering a medication, unaware of another medication the patient is taking that could interact with the new prescription. Using the same pharmacist for all prescriptions will also help to prevent this from happening. Informing the provider of all medications taken will not reduce costs of medications, which is best accomplished by requesting generic medications. Allergies should be disclosed to all health care providers as well, but this is not why it is important to provide a complete list of medications taken. Critical concentrations are desirable because that is the amount of drug needed to cause a therapeutic effect, or, in other words, to have the effect the drug is prescribed for.
Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
- A. This is a parasympathetic response to the vasodilating effects of the drug.
- B. Headaches are common side effects with these drugs. How severe are they?
- C. This is associated with your smoking. Let's work on having you stop smoking.
- D. This is not related to your medication. Are you under a lot of stress?
Correct Answer: B
Rationale: Headaches are a common nitrate side effect due to vasodilation.
A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC) Pepcid to relieve acid indigestion for several years. This is the first time the patient has ever reported this issue to a health care provider. As part of the teaching plan for this patient, the nurse explains what risk associated with not sharing OTC drug use with the provider?
- A. The OTC drug could be more expensive than seeking health care advice.
- B. The drug could mask symptoms of a serious problem that is undiagnosed.
- C. Use of the drug could cause a rebound effect of Pepcid.
- D. The drug could interact with several cold medicines.
Correct Answer: B
Rationale: OTC drugs allow patients to self-diagnose and treat routine signs and symptoms without seeing a health care provider. This self-prescribed treatment, however, could mask a more serious underlying medical problem and result in a poor outcome for the patient. The issues of drug rebound and drug interaction need to be considered, but the safety issue related to self-diagnosis and self-prescription presents the greatest risk to the patient. Patients should always be encouraged to discuss the use of OTC products with their health care provider.