A 60-year-old female with chronic pain is prescribed tramadol. Tramadol works primarily by:

Correct Answer: B

Rationale: The correct answer is B because tramadol primarily works by inhibiting the reuptake of serotonin and norepinephrine in the brain. This mechanism of action helps to modulate pain signals and increase pain tolerance. Choice A is incorrect because tramadol has weak affinity for opioid receptors. Choice C is incorrect as tramadol does not inhibit prostaglandin synthesis like NSAIDs. Choice D is incorrect as blocking sodium channels is the mechanism of action for local anesthetics, not tramadol.

Correct Answer: D

Rationale: The correct answer is D: Venlafaxine. Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI), which works by blocking the reuptake of serotonin and norepinephrine in the brain, thereby increasing the levels of these neurotransmitters. This helps alleviate symptoms of depression. Rationale: 1. Sertraline (A) is a selective serotonin reuptake inhibitor (SSRI), primarily targeting serotonin. 2. Amitriptyline (B) is a tricyclic antidepressant that primarily acts on norepinephrine and serotonin reuptake, but it is not as selective as Venlafaxine. 3. Citalopram (C) is an SSRI that primarily targets serotonin reuptake, not norepinephrine. In summary, Venlafaxine is the correct choice as it specifically inhibits both serotonin and norepinephrine reuptake

Correct Answer: B

Rationale: The correct answer is B: Inhibiting the reuptake of serotonin and norepinephrine. Tramadol is a centrally-acting synthetic opioid analgesic that works by inhibiting the reuptake of these neurotransmitters in the brain. This action enhances their analgesic effects, providing pain relief. Choice A is incorrect because tramadol's mechanism is not primarily through binding to opioid receptors like traditional opioids. Choice C is incorrect as tramadol does not directly inhibit prostaglandin synthesis. Choice D is incorrect as tramadol does not primarily block sodium channels in peripheral nerves.

Correct Answer: B

Rationale: The correct answer is B because tramadol primarily works by inhibiting the reuptake of serotonin and norepinephrine. This mechanism of action helps to modulate the perception of pain in the central nervous system. Tramadol's opioid activity is weaker compared to other opioids, so it is not the primary mechanism of action. Inhibiting prostaglandin synthesis is the mechanism of NSAIDs, not tramadol. Blocking sodium channels in peripheral nerves is the mechanism of local anesthetics, not tramadol. Therefore, choice B is the most appropriate mechanism of action for tramadol in managing chronic pain.

Correct Answer: C

Rationale: Rationale: Chloroquine is the correct answer as it is a well-established antimalarial drug targeting Plasmodium. It works by inhibiting the parasite's ability to break down hemoglobin. Clindamycin (A), Doxycycline (B), and Penicillin (D) are not typically used for treating malaria. Clindamycin is more commonly used for anaerobic infections, Doxycycline for bacterial infections, and Penicillin for bacterial infections unrelated to malaria.