Which of the following adverse effects are less likely in a beta1-selective blocker?
Impaired insulin release
Reflex orthostatic changes
Decreased triglycerides and cholesterol
Question 3 1 / 1 point
Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:
Symptoms are severe
Patient has not responded to other therapies
Patient has concurrent hypertension
Left ventricular dysfunction is diagnosed
Question 4 1 / 1 point
You are treating a patient with a diagnosis of Alzheimer’s disease. The patient’s wife mentions difficulty with transportation to the clinic. Which medication is the best choice?
Question 5 1 / 1 point
Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.
Rectal diazepam (Diastat)
IV phenytoin (Dilantin)
Oral carbamazepine (Tegretol)
Question 6 1 / 1 point
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
Dwayne hasn’t been taking his carbamazepine because it causes insomnia.
Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
Dwayne was not originally prescribed the correct amount of carbamazepine.
Carbamazepine is probably not the right antiseizure medication for Dwayne.
Question 7 1 / 1 point
Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:
Acetaminophen with hydrocodone (Vicodin)
Oral morphine (Roxanol)
Question 8 1 / 1 point
Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:
Slurred speech and insomnia
Bradycardia and confusion
Dizziness and orthostatic hypotension
Insomnia and decreased appetite
Question 9 1 / 1 point
An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:
Question 10 1 / 1 point
David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:
Paroxetine may cause intermittent diarrhea.
He may experience sexual dysfunction beginning a month after he starts therapy.
He may have constipation and he should increase fluids and fiber.
Paroxetine has a long half-life so he may occasionally skip a dose.
Question 11 1 / 1 point
An appropriate drug for the treatment of depression with anxiety would be:
Question 12 1 / 1 point
The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason?
They have become tolerant of the medication, which is characterized by the need for higher and higher doses.
They are a drug seeker.
They are suicidal.
They only need additional counseling on lifestyle modification.
Question 13 1 / 1 point
A first-line drug for abortive therapy in simple migraine is:
Butorphanol nasal spray (Stadol NS)
Butalbital and acetaminophen (Fioricet)
Question 14 1 / 1 point
Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate decision making would be:
Prescribe the Maxalt, but only give her four tablets with no refills to monitor the use.
Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.
Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).
Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.
Question 15 1 / 1 point
Kelly is a 14-year-old patient who presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be:
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