A 35-year-old female presents to your office for a regular check-up. Her only complaint is recurrent migraine headaches, which have increased in frequency over the years. On examination, her blood pressure is elevated at 150/70. You decide to start her on antihypertensive therapy that is also used for prophylaxis of migraines. Which medication is it?

Correct Answer: D

Rationale: The correct answer is D: Propranolol. Propranolol is a beta-blocker that is commonly used for migraine prophylaxis. It helps reduce the frequency and severity of migraines by blocking the action of adrenaline on blood vessels in the brain. In this case, the patient has elevated blood pressure and migraines, so starting her on propranolol can address both issues effectively. Choice A: Clonidine is an alpha-2 agonist used for hypertension, but it is not commonly used for migraine prophylaxis. Choice B: Prazosin is an alpha-1 blocker primarily used for the treatment of hypertension, but it is not typically used for migraine prophylaxis. Choice C: Hydrochlorothiazide is a diuretic used for hypertension by reducing blood volume, but it is not effective for migraine prophylaxis. In summary, propranolol is the most appropriate choice as it addresses both the elevated blood pressure and the recurrent

Correct Answer: D

Rationale: Correct Answer: D. Increases blood flow to the injection area. Rationale: 1. Adrenaline is a vasoconstrictor that reduces blood flow in the injection area. 2. By constricting blood vessels, adrenaline limits the absorption of the local anesthetic, leading to prolonged local action. 3. Adrenaline also helps in reducing the systemic toxicity of the local anesthetic by limiting its absorption. 4. Therefore, the correct answer is D as adrenaline does not increase blood flow to the injection area.

Correct Answer: A

Rationale: The correct answer is A: Excessive salivation. Atropine is an anticholinergic medication that blocks the action of acetylcholine, leading to decreased secretions including saliva. Excessive salivation is not an adverse effect but rather a therapeutic effect of atropine. Choices B, C, and D are incorrect because retention of urine, sinus tachycardia, and constipation are known adverse effects of atropine due to its anticholinergic properties.

Correct Answer: D

Rationale: The correct answer is D: Tachycardia. Anticholinergic medications block the action of acetylcholine, leading to increased heart rate (tachycardia) by inhibiting the parasympathetic nervous system. Excessive salivation (choice A) is a cholinergic effect, not anticholinergic. Bradycardia (choice B) is not consistent with anticholinergic side effects. Diarrhea and colic (choice C) are more commonly associated with cholinergic, not anticholinergic, effects.

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Prazosin and phentolamine both antagonize alpha1-receptors, leading to vasodilation and decreased blood pressure. 2. Both drugs are competitive antagonists, competing with norepinephrine at alpha1-receptors. 3. However, phentolamine causes reflex tachycardia due to its non-selective alpha-adrenergic blockade, unlike prazosin. 4. Therefore, the statement that both cause the same degree of tachycardia is incorrect based on their pharmacological differences.