A patient is concerned about the adverse effects of the fibric acid derivative she is taking to lower her cholesterol level. Which is an adverse effect of this class of medication?

Correct Answer: C

Rationale: Adverse effects of fibric acid derivatives, also known as fibrates, may include joint pain among other side effects such as gastrointestinal symptoms, abnormalities in liver function tests, and myopathy (muscle damage). Joint pain can be a result of musculoskeletal side effects associated with fibrates, so it is important for the patient to report any new or worsening joint pain to their healthcare provider.

Correct Answer: A

Rationale: The therapeutic serum range for phenobarbital (luminal) when used for anxiety is typically between 5-10 mcg/ml. This range is considered effective in controlling anxiety symptoms while minimizing the risk of toxicity. Higher serum levels (options B, C, D) may increase the risk of adverse effects such as sedation, respiratory depression, and overdose. Therefore, monitoring the serum levels of phenobarbital is essential to ensure the medication is at a therapeutic range for the intended treatment.

Correct Answer: D

Rationale: Erectile dysfunction drugs like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are contraindicated with Nitroglycerin. Both Nitroglycerin and erectile dysfunction drugs work by lowering blood pressure. When taken together, they can cause a significant drop in blood pressure leading to dizziness, fainting, and even serious complications like low blood pressure and decreased oxygen supply to the heart. Therefore, it is important to avoid using these medications together to prevent potential harm.

Correct Answer: D

Rationale: The therapeutic range for lithium is generally considered to be 0.6-1.2 mmol/L (which is equivalent to 0.6-1.2 mEq/L). However, some sources may state a slightly wider range of 0.5-1.5 mEq/L. It is important to note that individual patient factors and clinical judgment should also be considered when interpreting lithium levels. Levels below the therapeutic range may be subtherapeutic and not provide the desired therapeutic effect, while levels above the range may result in toxicity and adverse effects. Monitoring lithium levels regularly is important to ensure they remain within the therapeutic range.

Correct Answer: C

Rationale: Montelukast is commonly administered orally, which stands for "per os" meaning by mouth. This medication is available in tablet, chewable tablet, and oral granule formulations for easy ingestion. It is not administered intravenously (IV), intramuscularly (IM), or subcutaneously (SubQ) as it is primarily used for oral administration to treat asthma and allergic rhinitis.