A 72-year old woman with a long history of anxiety that has been treated with diazepam decides to triple her daily dose. Two days after her attempts at self-prescribing, she is found extremely lethargic and non-responsive. Respiration is 8/min and shallow. Which of the following drugs should we give to reverse these signs and symptoms?

Correct Answer: B

Rationale: Flumazenil (choice B) reverses benzodiazepine (diazepam) overdose, countering lethargy and respiratory depression by antagonizing GABAa receptors. Amphetamine (choice A) stimulates, Naltrexone (choice C) blocks opioids, and Physostigmine (choice D) treats anticholinergic toxicity. Flumazenil is specific.

Correct Answer: B

Rationale: Metformin's adverse effects include lactic acidosis (choice A), a rare but serious risk due to lactate accumulation, especially in renal impairment; nausea (choice C), a common GI upset; and vitamin B12 interference (choice D), from altered absorption. Hypoglycemia (choice B) is not typical, as Metformin reduces hepatic glucose output and enhances insulin sensitivity without directly stimulating insulin release, unlike sulfonylureas. This exception underscores Metformin's safety profile in type 2 diabetes, avoiding the hypoglycemic risk of secretagogues. Understanding this is vital for prescribing, monitoring renal function to prevent lactic acidosis, and addressing B12 deficiency in long-term users.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.