Which of the following is a side effect of propylthiouracil?
- A. Agranulocytosis
- B. Arrhythmias
- C. Diabetes
- D. Hypertension
Correct Answer: A
Rationale: Propylthiouracil can cause agranulocytosis, a severe drop in white blood cells.
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All the following induce hepatic enzymes except
- A. Rifampicin
- B. Phenytoin
- C. Barbiturates
- D. Tolbutamide
Correct Answer: D
Rationale: Tolbutamide does not significantly induce enzymes; others do.
Information technology can be a time-saving device in a busy practice if it is used wisely. One way to make it a help rather than a hindrance is to:
- A. Prioritize what is needed information and spond spending time reading 'interesting' information not central to the problem at hand
- B. Integrate professional and personal searching so that the same browser does not need to be accessed repeatedly
- C. Check e-mail frequently so that patient questions can be addressed promptly
- D. Check for viruses, spyware, and malware
Correct Answer: A
Rationale: Prioritizing relevant information saves time in a busy practice.
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
- A. Toxic levels of warfarin building up
- B. Decreased response to warfarin
- C. Increased risk for significant drug interactions with warfarin
- D. Less risk of drug interactions with warfarin
Correct Answer: B
Rationale: VCORC1 mutations reduce warfarin's anticoagulant effect , requiring higher doses, not toxicity or interaction changes .
The nurse, assisting with Phase I drug studies, is talking with a woman who asks, Why cant I participate in this study? What would be the nurses best response?
- A. Drugs pose a greater risk to women of reproductive age.
- B. Drugs are only tested on men because they are stronger.
- C. Women are more prone to adverse effects from medications.
- D. Drugs affect women differently than they affect women.
Correct Answer: A
Rationale: Phase I drug trials usually involve healthy male volunteers because chemicals may exert an unknown and harmful effect on ova in women which could result in fetal damage when the woman becomes pregnant. Drugs are tested on both men and women, but women must be fully informed of risks and sign a consent stating they understand the potential for birth defects. Women are not more prone to adverse effects of medications. Although some drugs may affect women differently than men, this is a rationale for why drugs need to be tested on women, not an explanation of why women are not included in a Phase I study.
A 66-year-old man is admitted to the hospital with confusion, nausea, and blurred vision. He is currently on digoxin for the treatment of heart failure. On physical exam, his heart rate is 120 bpm. Further evaluation reveals a digoxin level of 5.3 ng/mL (normal range: 0.5-2 ng/mL). The doctor believes his symptoms are due to digoxin toxicity. Which parameter is used to indicate the ability of digoxin to produce the desired effect relative to a toxic effect?
- A. Bioavailability
- B. Efficacy
- C. Intrinsic activity
- D. Therapeutic index
Correct Answer: D
Rationale: Therapeutic index (TI) measures the relative safety of a drug by comparing the dose required for a therapeutic effect to the dose that produces toxicity. In this case, digoxin toxicity is indicated by the elevated level, and TI is the relevant parameter.