A patient has been prescribed Citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:

Correct Answer: B

Rationale: Step-by-step rationale: 1. SSRI antidepressants like Citalopram typically take time to build up in the body and exert their full therapeutic effects. 2. It usually takes about 2 to 4 weeks to start noticing improvements in symptoms like mood, appetite, and concentration. 3. The full response to the SSRI may take 2 to 4 months after reaching the full therapeutic dose due to the gradual adjustment of serotonin levels. 4. Therefore, educating the patient that full response may take 2 to 4 months after reaching the full therapeutic dose is important for managing expectations and ensuring compliance with the treatment plan. Summary: - Option A is incorrect as improvements in symptoms do not occur immediately upon starting Citalopram. - Option C is incorrect as improvements in appetite and concentration typically take longer than 1 to 2 weeks. - Option D is incorrect as the improvement in dysphoric mood may take longer than 1 to 2 weeks.

Correct Answer: D

Rationale: The correct answer is D: Displacement. When two drugs compete for the same receptor site, one drug can displace the other, leading to increased activity of the first drug. This phenomenon is known as drug displacement. A: Desired action does not describe the competition between drugs for the same receptor site. B: Synergistic effect refers to when two drugs work together to produce a greater effect than the sum of their individual effects. C: Carcinogenicity relates to the ability of a substance to cause cancer, and is not relevant to the scenario described in the question.

Correct Answer: A

Rationale: The correct answer is A: Cryptococcus neoformans: amphotericin B. Cryptococcus neoformans is a fungus causing severe meningitis in immunocompromised individuals. Amphotericin B is the first-line treatment for cryptococcal meningitis due to its efficacy against the pathogen. It works by binding to ergosterol in the fungal cell membrane, disrupting membrane integrity. Griseofulvin (choice B) is used for dermatophyte infections like Trichophyton, not for Cryptococcus. Fluconazole (choice C) is used for Histoplasma and Aspergillus infections but not as effective against Cryptococcus as amphotericin B. Aspergillus fumigatus is commonly treated with voriconazole or amphotericin B, not fluconazole as in choice D.

Correct Answer: D

Rationale: The correct answer is D: Voriconazole. This drug is appropriate for the patient as it is a broad-spectrum antifungal agent commonly used to treat invasive fungal infections. It is effective against a wide range of fungal species, including Candida and Aspergillus. Voriconazole has good tissue penetration and high bioavailability, making it suitable for serious systemic fungal infections. Flucytosine (A) is mainly used in combination with other antifungal agents and is not a standalone therapy. Terbinafine (B) is primarily used for dermatophyte infections and not for systemic fungal infections. Griseofulvin (C) is used for superficial fungal infections like ringworm and is not effective against systemic fungal infections like those requiring Voriconazole.

Correct Answer: B

Rationale: The correct answer is B: Enoxaparin. Enoxaparin is a low molecular weight heparin commonly prescribed for post-surgery blood clot prevention due to its effectiveness in inhibiting blood clot formation. Warfarin (A) is primarily used for long-term anticoagulation therapy, not typically for post-surgery prevention. Aspirin (C) is a mild antiplatelet agent and is not as effective as enoxaparin for post-surgery clot prevention. Clopidogrel (D) is also an antiplatelet drug but is not commonly prescribed for post-surgery blood clot prevention.