A 49-year-old man with manic depression has been maintained on lithium for long-term therapy. However, because of worsening of symptoms, he is placed on ziprasidone. The patient must be warned about which of the following adverse effects?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Slowing of heart rate. Ziprasidone is an atypical antipsychotic medication that can cause QT interval prolongation, which may lead to a slowing of the heart rate, known as bradycardia. It is crucial to warn the patient about this potential adverse effect to prevent any complications. Option A) Asthenia refers to weakness or lack of energy. While this can be a side effect of some medications, it is not a common adverse effect of ziprasidone. Option B) Erectile dysfunction is a possible side effect of many psychiatric medications, including some antipsychotics, but it is not specifically associated with ziprasidone. Option C) Hypertension is not a typical adverse effect of ziprasidone. In fact, ziprasidone is considered to have a relatively neutral effect on blood pressure compared to other antipsychotic medications. Educationally, understanding the potential adverse effects of medications is crucial for healthcare providers to effectively educate patients on what to expect and how to manage them. In this case, being aware of the risk of slowing heart rate with ziprasidone can help healthcare providers monitor patients closely and provide appropriate warnings and interventions to ensure patient safety and well-being.

Correct Answer: A

Rationale: Acute gout attacks require rapid inflammation reduction. Colchicine (choice B) disrupts microtubule function, reducing neutrophil activity. Indomethacin (choice C), an NSAID, inhibits COX, lowering prostaglandin levels. Glucocorticoids (choice D) suppress inflammation broadly. Allopurinol (choice A), a xanthine oxidase inhibitor, lowers uric acid long-term but doesn't address acute inflammation, making it the exception. This distinction guides acute versus chronic gout management.

Correct Answer: A

Rationale: Colchicine (choice B) treats acute gout by reducing inflammation, Allopurinol (choice C) lowers uric acid long-term, and Sulphinpyrazone (choice D) promotes urate excretion. Thiazide diuretics (choice A) increase uric acid retention, worsening gout, making them the exception. This distinguishes gout management from contraindicated drugs.

Correct Answer: D

Rationale: Flurazepam (choice A), Triazolam (choice B), and Chlordiazepoxide (choice C), all benzodiazepines, initiate sleep via GABAa potentiation, differing in duration (long, short, intermediate). ‘All of the above' (choice D) is correct, as each is a hypnotic, tailored to insomnia needs, highlighting benzodiazepine versatility.

Correct Answer: B

Rationale: In this question, the correct answer is B) Hepatic microsomal enzyme induction. MAO inhibitors are a class of drugs used to treat depression and other psychiatric conditions by inhibiting the activity of monoamine oxidase enzymes. The side effects of MAO inhibitors are well-documented, and one of the common side effects is the "cheese reaction," which is due to the interaction of these drugs with tyramine-containing foods like cheese, leading to hypertensive crisis. This is why option A is incorrect. Hepatotoxicity is a known potential side effect of MAO inhibitors, making option C incorrect. However, hepatic microsomal enzyme induction is not typically associated with MAO inhibitors. Instead, it is a property of certain other drug classes like carbamazepine or phenobarbital. Understanding the side effects of medications is crucial for healthcare professionals to ensure safe and effective patient care. Recognizing the side effects helps in monitoring patients for adverse reactions and taking necessary precautions. This knowledge also guides medication selection and management strategies in clinical practice.