Nokea
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the natural mineralocorticoid regulating sodium and potassium balance.
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An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).
Clonidine has several off-label uses, including:
- A. Alcohol and nicotine withdrawal
- B. Post-herpetic neuralgia
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Clonidine is used off-label for both alcohol/nicotine withdrawal and post-herpetic neuralgia.
What concept is considered when generic drugs are substituted for brand name drugs?
- A. Bioavailability
- B. Critical concentration
- C. Distribution
- D. Half-life
Correct Answer: A
Rationale: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand name drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a generic drug substitution. Critical concentration is the amount of a drug that is needed to cause a therapeutic effect and should not differ between generic and brand name medications. Distribution is the phase of pharmacokinetics, which involves the movement of a drug to the body's tissues and is the same in generic and brand name drugs. A drug's half-life is the time it takes for the amount of drug to decrease to half the peak level, which should not change when substituting a generic medication.
The combination of propranolol & nifedipine in essential hypertension is used because
- A. CNS effects of propanolol are prevented
- B. Pedal edema of nifedipine is prevented
- C. Alteration of serum lipids by propranolol is prevented
- D. Reflex sympathetic activity of nifedipine is prevented
Correct Answer: D
Rationale: Propranolol (beta-blocker) counters nifedipine's (calcium channel blocker) reflex tachycardia.
A patient with an edema would have an increased volume of distribution (Vd) if?
- A. The patient was taking an anionic drug
- B. The patient was taking a hydrophobic drug
- C. The patient was taking a hydrophilic drug
- D. An edema always causes an increase in Vd
Correct Answer: C
Rationale: Edema increases extracellular fluid, raising Vd for hydrophilic drugs that distribute into this compartment, not hydrophobic drugs (tissue-bound) or universally.