A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe

Correct Answer: D

Rationale: Milrinone is a phosphodiesterase inhibitor used to improve cardiac contractility and reduce pulmonary congestion in patients with heart failure. Furosemide is a loop diuretic used to reduce fluid volume in patients with congestive heart failure. Given that both milrinone and furosemide are typically administered intravenously and may have potentially incompatible effects on fluid and electrolyte balance, it is critically important to administer them separately. Mixing these medications in the same intravenous line can lead to potential drug interactions or decrease the effectiveness of either drug.

Correct Answer: B

Rationale: The therapeutic range for digoxin levels is typically considered to be between 0.5 to 2.0 ng/mL for patients with heart failure. A digoxin level of 1.1 ng/mL falls within this range, indicating that the patient's digoxin level is appropriate for therapeutic effects. This level suggests that the patient is receiving an appropriate dose of digoxin to achieve the desired therapeutic response without reaching toxic levels.

Correct Answer: B

Rationale: Naloxone is the antidote commonly used to reverse the effects of opioid toxicity, including hydrocodone. Naloxone works by competitively binding to opioid receptors in the brain, displacing the opioid molecules, and reversing their effects. It effectively antagonizes the respiratory depression, sedation, and analgesic effects caused by opioids like hydrocodone. Administering naloxone can quickly reverse these dangerous effects and help restore respiratory function in cases of opioid overdose or toxicity. Naloxone is commonly used in emergency settings and can be administered intravenously, intramuscularly, or intranasally. It is crucial for healthcare providers to be familiar with naloxone and its administration in managing opioid toxicity.

Correct Answer: B

Rationale: Omeprazole is classified as an antiulcer agent. It belongs to the class of medications known as proton pump inhibitors (PPIs), which work by reducing the production of stomach acid. Omeprazole is commonly used to treat conditions such as gastroesophageal reflux disease (GERD), peptic ulcers, and Zollinger-Ellison syndrome. Its main therapeutic effects include reducing stomach acid secretion and promoting the healing of ulcers.

Correct Answer: C

Rationale: Propranolol goes through extensive first-pass hepatic metabolism. This means that after oral administration, a significant portion of the drug is metabolized by the liver before it reaches systemic circulation. This process reduces the bioavailability of propranolol. As a result, higher doses are often required for oral administration compared to other routes of administration, such as intravenous. Heparin, insulin, nitroglycerine, and warfarin do not undergo extensive first-pass metabolism in the liver.