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A group of volunteers are included in a phase I clinical trial of a new drug acting on the autonomic nervous system. With intravenous bolus administration of the drug, blood pressure increases. When the same drug is administered orally for a week, blood pressure is lowered. The effects of which of the specified standard drugs resemble the tested drug?
A group of volunteers are included in a phase I clinical trial of a new drug acting on the autonomic nervous system. With intravenous bolus administration of the drug, blood pressure increases. When the same drug is administered orally for a week, blood pressure is lowered. The effects of which of the specified standard drugs resemble the tested drug?
A 22-year-old patient involved in a driving under the influence (DUI) related car accident is brought into the ED by ambulance. Due to the patient's severe injuries and high risk for gastric aspiration, the ED physician decides to initiate a rapid sequence intubation to maintain and protect his airway prior to surgery. An intravenous line is placed in the patients arm, and the patient is given a bolus of propofol (general anesthetic) mixed with lidocaine. This injection is followed immediately by a bolus of a rapidly acting depolarizing neuromuscular blocking agent. Once the muscles in the neck become relaxed, an endotracheal tube is inserted, and mechanical ventilation is initiated, followed by maintenance of general anesthesia using inhaled sevoflurane. What was the most likely drug given to produce rapid skeletal muscle relaxation immediately prior to intubation?
A 22-year-old patient involved in a driving under the influence (DUI) related car accident is brought into the ED by ambulance. Due to the patient's severe injuries and high risk for gastric aspiration, the ED physician decides to initiate a rapid sequence intubation to maintain and protect his airway prior to surgery. An intravenous line is placed in the patients arm, and the patient is given a bolus of propofol (general anesthetic) mixed with lidocaine. This injection is followed immediately by a bolus of a rapidly acting depolarizing neuromuscular blocking agent. Once the muscles in the neck become relaxed, an endotracheal tube is inserted, and mechanical ventilation is initiated, followed by maintenance of general anesthesia using inhaled sevoflurane. What was the most likely drug given to produce rapid skeletal muscle relaxation immediately prior to intubation?
A nurse prepares to administer medication to several patients. In which case should the nurse ask for clarification?
A nurse prepares to administer medication to several patients. In which case should the nurse ask for clarification?
A 33-year-old White female presents to the clinic complaining of difficulty carrying out daily chores for the last week. Her history is remarkable for the diagnosis of Multiple Sclerosis made one year ago. She has numbness and painful spasms in the upper and lower extremities. She denies blurry or double vision, incontinence, vertigo, or tingling sensation. Vital signs are within normal limits. There is increased spasticity in all four limbs, and hyperreflexia is also present in lower extremities. Which of the following would be the most appropriate medication for this patient?
A 33-year-old White female presents to the clinic complaining of difficulty carrying out daily chores for the last week. Her history is remarkable for the diagnosis of Multiple Sclerosis made one year ago. She has numbness and painful spasms in the upper and lower extremities. She denies blurry or double vision, incontinence, vertigo, or tingling sensation. Vital signs are within normal limits. There is increased spasticity in all four limbs, and hyperreflexia is also present in lower extremities. Which of the following would be the most appropriate medication for this patient?
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Neuronal cells located in the substantia nigra have external projections to the striatum. The neurotransmitter that is released, which only has an inhibitory effect, is most likely?
Neuronal cells located in the substantia nigra have external projections to the striatum. The neurotransmitter that is released, which only has an inhibitory effect, is most likely?
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Like many other drugs used in treating different psychiatric disorders, atypical "antipsychotics" have been approved for treating more than one type of psychiatric disorder. Which other condition are these drugs commonly used for?
Like many other drugs used in treating different psychiatric disorders, atypical "antipsychotics" have been approved for treating more than one type of psychiatric disorder. Which other condition are these drugs commonly used for?
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Emetics are not used as frequently as they were in the past to treat cases of drug overdose or poisoning. One situation where they are absolutely contraindicated is in the treatment of:
Emetics are not used as frequently as they were in the past to treat cases of drug overdose or poisoning. One situation where they are absolutely contraindicated is in the treatment of:
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A patient prescribed infliximab (anti-TNF-alfa antibody) for rheumatoid arthritis developed a temperature of 39°C, chills, nausea, vomiting and dizziness. What should this patient be advised?
A patient prescribed infliximab (anti-TNF-alfa antibody) for rheumatoid arthritis developed a temperature of 39°C, chills, nausea, vomiting and dizziness. What should this patient be advised?
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Which statement about prostacyclin is true?
Which statement about prostacyclin is true?
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A 17-year-old female patient presents to the hospital due to recurrent headaches for the past two years. The patient describes headaches as right-sided, throbbing in nature, 9/10 in intensity, and lasting throughout the day's work. She also notes occasional nausea and photophobia. She associates these symptoms with increasing stress in her school. Which of the following best describes the prophylaxis for this patient?
A 17-year-old female patient presents to the hospital due to recurrent headaches for the past two years. The patient describes headaches as right-sided, throbbing in nature, 9/10 in intensity, and lasting throughout the day's work. She also notes occasional nausea and photophobia. She associates these symptoms with increasing stress in her school. Which of the following best describes the prophylaxis for this patient?
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What is the reason that some countries in the world require part of the names of some drugs to be written in capital letters in the prescriptions (eg buSPIron and buPROpion) (the “tall man" letters)?
What is the reason that some countries in the world require part of the names of some drugs to be written in capital letters in the prescriptions (eg buSPIron and buPROpion) (the “tall man" letters)?
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A patient was prescribed nitroglycerin 55 mcg/min. It is available as a 25 mg/250 ml (100 mcg/ml) solution. What is the infusion rate?
A patient was prescribed nitroglycerin 55 mcg/min. It is available as a 25 mg/250 ml (100 mcg/ml) solution. What is the infusion rate?
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A patient is taking 100 mg of hydrocortisone IV every 8 hours and is being switched to oral prednisone. What is the equivalent dose?
A patient is taking 100 mg of hydrocortisone IV every 8 hours and is being switched to oral prednisone. What is the equivalent dose?
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A 36-year-old woman presents to the clinic with a complaint of pain and swelling in both hands and wrists. She reports morning stiffness that lasts for approximately 30 minutes, which later improves. She was diagnosed with rheumatoid arthritis 3 months ago following a positive anti-CCP and rheumatoid factor and elevated ESR and CRP. She was started on methotrexate and folic acid during that time. Despite taking the medication, she is still experiencing symptoms and complains the medication is not working. On the physical exam, there is decreased grip strength bilaterally and tenderness to palpation and swelling of the proximal interphalangeal joints and metacarpophalangeal joints. A JAK inhibitor targeting JAK-3 and JAK-1 enzymes is being considered. Which of the following adverse effects is most likely to occur with the use of this medication in this patient?
A 36-year-old woman presents to the clinic with a complaint of pain and swelling in both hands and wrists. She reports morning stiffness that lasts for approximately 30 minutes, which later improves. She was diagnosed with rheumatoid arthritis 3 months ago following a positive anti-CCP and rheumatoid factor and elevated ESR and CRP. She was started on methotrexate and folic acid during that time. Despite taking the medication, she is still experiencing symptoms and complains the medication is not working. On the physical exam, there is decreased grip strength bilaterally and tenderness to palpation and swelling of the proximal interphalangeal joints and metacarpophalangeal joints. A JAK inhibitor targeting JAK-3 and JAK-1 enzymes is being considered. Which of the following adverse effects is most likely to occur with the use of this medication in this patient?
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Glucocorticoid-mediated suppression of the inflammatory response has important pharmacologic implications for the treatment of conditions such as organ transplantation, asthma, rheumatoid arthritis & other autoimmune disorders such as lupus. The anti-inflammatory effects of glucocorticoids are known to be mediated by multiple mechanisms. Which of the following is one such mechanism?
Glucocorticoid-mediated suppression of the inflammatory response has important pharmacologic implications for the treatment of conditions such as organ transplantation, asthma, rheumatoid arthritis & other autoimmune disorders such as lupus. The anti-inflammatory effects of glucocorticoids are known to be mediated by multiple mechanisms. Which of the following is one such mechanism?
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Which of the following statements about the pharmacokinetics of antiepileptic drugs is most accurate?
Which of the following statements about the pharmacokinetics of antiepileptic drugs is most accurate?
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Which statement concerning herbal supplements is NOT true?
Which statement concerning herbal supplements is NOT true?
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Which drug is used to treat myasthenia gravis by increasing muscle strength?
Which drug is used to treat myasthenia gravis by increasing muscle strength?
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According to the American Urological Association (AUA), with which class of drugs should B-3 agonists be used?
According to the American Urological Association (AUA), with which class of drugs should B-3 agonists be used?
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Study Notes
Clinical Trial of New Drug
- A group of volunteers is participating in a phase I clinical trial of a novel drug affecting the autonomic nervous system.
- Intravenous administration of the drug increases blood pressure.
- Oral administration of the drug for one week lowers blood pressure.
- The drug's effects mimic those of a standard drug, potentially clonidine (alpha-2 agonist).
Patient with DUI Accident
- A 22-year-old patient involved in a DUI-related car accident is admitted to the emergency department (ED).
- The patient is suffering significant injuries and a high risk of gastric aspiration.
- Rapid sequence intubation is performed to secure the airway.
- Propofol and succinylcholine (a rapid-acting depolarizing neuromuscular blocking agent) are administered.
Nurse Medication Administration
- A nurse is preparing to administer medications to several patients.
- Drowsiness might be an adverse effect of the medication
- For a patient with muscle spasms, dantrolene sodium is administered.
- For a patient with narrow-angle glaucoma, diazepam is contraindicated due to its effects on intraocular pressure.
- Anti-acetylcholine receptor antibody tests are performed on patients with myasthenia gravis
- A patient with muscle injury could be treated with chlorzoxazone.
Multiple Sclerosis Patient
- A 33-year-old woman with a history of multiple sclerosis (MS) experiences increasing muscle spasms and pain in her upper and lower limbs.
- Increased spasticity and hyperreflexia in her lower extremities are observed.
- Baclofen, a muscle relaxant, is the appropriate medication for the patient.
GABA Receptor
- Baclofen, a GABA-B receptor agonist, is considered an effective monotherapy for treating MS-related spasticity.
- Tizanidine (alpha-2 adrenergic agonist) and diazepam (benzodiazepine) are also used for the same purpose.
- Acute exacerbations of MS are treated with glucocorticoids.
Neurotransmitter in Substantia Nigra
- Dopamine is a neurotransmitter in the substantia nigra, which has external projections to the striatum.
- Dopamine's effect in the synapses is slow and inhibitory.
Drugs for Psychiatric Conditions
- Atypical antipsychotics are approved to treat multiple psychiatric disorders.
- These drugs are used to treat major depressive disorder in cases of resistance to other treatments such as SSRIs or SNRIs.
Drug Overdose
- Emetics (e.g., ipecac syrup) are less commonly used for drug overdoses compared to the past.
- They are contraindicated in kerosene poisoning due to the risk of pulmonary aspiration.
Medication for Rheumatoid Arthritis
- Tofacitinib, a JAK inhibitor, is used to manage rheumatoid arthritis.
- The common adverse effects associated with Tofacitinib include upper respiratory tract infections (URTI), rash, nausea, diarrhea, hypertension, and anemia.
Prostate Cancer Screening
- Yearly prostate-specific antigen (PSA) screening is not recommended.
- The decision for screening should be made on an individual basis, considering the patient's risk factors. African American men have a higher risk of prostate cancer.
Hydrocortisone Equivalent Dose
- For a patient receiving 100 mg of intravenous hydrocortisone every 8 hours, an equivalent dose of oral prednisone would be 25 mg.
- An equivalent dose of a steroid depends on its anti-inflammatory potency, with hydrocortisone as 1:1 and dexamethasone as having greater than 30:1 potency.
Tofacitinib
- Tofacitinib is an FDA-approved Janus kinase (JAK) inhibitor, used in the management of rheumatoid arthritis.
- Common adverse effects include upper respiratory tract infections, nasopharyngitis, diarrhea, gastrointestinal issues, nausea, headache, skin rashes, increased blood cholesterol and elevated blood creatine phosphokinase.
Herbal Supplements
- "Blanket statements" about the effects of herbal supplements are not accurate, as there is often insufficient evidence to support claims.
- Herbal supplements are categorized as food, not drugs.
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Description
This quiz covers vital topics in clinical trials for new drugs, focusing on their physiological effects and emergency care for trauma patients. It also includes medication administration protocols among nurses and considerations for patient safety. Test your knowledge on these essential aspects of medical practice.
