An anxiolytic useful in a patient with a history of drug dependence is:

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Buspirone. Buspirone is considered an appropriate choice for an anxiolytic in a patient with a history of drug dependence because it is less likely to cause the same degree of dependence or abuse potential as the other options. Alprazolam (B), Diazepam (C), and Lorazepam (D) are benzodiazepines, which have a higher potential for tolerance, dependence, and abuse compared to buspirone. Benzodiazepines can be problematic in patients with a history of drug dependence due to their reinforcing effects and potential for misuse. Educationally, understanding the appropriate selection of anxiolytics based on a patient's history of drug dependence is crucial for healthcare professionals, particularly in the field of pharmacology. It is essential to consider not only the efficacy of the medication but also its safety profile and potential for misuse when making prescribing decisions for patients with a history of substance use disorder. Buspirone's mechanism of action, which differs from benzodiazepines, makes it a safer choice in this specific patient population.

Correct Answer: D

Rationale: The correct answer is D) Both B & C. Nonselective MAOIs (monoamine oxidase inhibitors) are limited in use as antidepressants due to their high toxicity and potential to interact with many foods and drugs. MAOIs inhibit the enzyme monoamine oxidase, which breaks down neurotransmitters like serotonin, norepinephrine, and dopamine. By inhibiting this enzyme, MAOIs can increase the levels of these neurotransmitters in the brain, alleviating depression symptoms. However, nonselective MAOIs can interact with tyramine-rich foods (like aged cheeses, cured meats) and other medications, leading to hypertensive crisis or serotonin syndrome, which can be life-threatening. Option A, low efficacy, is not the primary reason for the limited use of nonselective MAOIs. They are actually effective antidepressants, but their use is restricted due to safety concerns. Educationally, it is crucial for students to understand the limitations and potential risks associated with different classes of antidepressants. This knowledge helps healthcare professionals make informed decisions when prescribing medications and monitoring patients for adverse effects. Understanding the rationale behind the limited use of nonselective MAOIs can enhance students' clinical reasoning skills and improve patient safety outcomes.

Correct Answer: D

Rationale: In the context of pharmacology, understanding the mechanism of action of different drugs is crucial for safe and effective prescribing. In this case, the correct answer is D) Selective serotonin reuptake inhibitor (SSRI) for the drug Fluoxetine. Fluoxetine is a commonly prescribed antidepressant that works by specifically inhibiting the reuptake of serotonin in the brain, leading to increased levels of serotonin in the synaptic cleft and improved mood in patients with depression. Option A) Norepinephrine serotonin reuptake inhibitor is incorrect because Fluoxetine primarily targets serotonin reuptake, not norepinephrine. Option B) Inhibitor of dopamine & NE reuptake is also incorrect as Fluoxetine does not significantly affect dopamine reuptake. Option C) Agonist/Partial 5HT1A agonist is incorrect as Fluoxetine is not an agonist but rather an inhibitor of serotonin reuptake. Educationally, this question helps students reinforce their understanding of different classes of psychotropic medications and their mechanisms of action. It highlights the importance of accurate drug selection based on their specific mechanisms to achieve the desired therapeutic effect. Understanding these principles is essential for healthcare professionals to make informed decisions when treating patients with mental health disorders.

Correct Answer: B

Rationale: Selective COX-2 inhibitors are a class of drugs that selectively inhibit the cyclooxygenase-2 enzyme, which is involved in inflammation and pain. The correct answer, option B, stating that selective COX-2 inhibitors have a low risk of cardiotoxicity and stroke, is false. In fact, these drugs have been associated with an increased risk of cardiovascular events, such as heart attacks and strokes. This risk led to the withdrawal of some COX-2 inhibitors from the market. Option A, stating that selective COX-2 inhibitors are associated with a low risk of gastric ulceration, is true. Compared to non-selective NSAIDs, COX-2 inhibitors are less likely to cause gastric ulcers and gastrointestinal bleeding. Option C, claiming that nephrotoxicity is a serious adverse effect of selective COX-2 inhibitors, is incorrect. Nephrotoxicity is not a common side effect associated with these drugs. However, renal function should be monitored in patients taking COX-2 inhibitors as a precaution. Option D states that Celecoxib should not be given to patients with sulfonamide allergy. This statement is true because Celecoxib has a sulfonamide moiety in its structure, which may cross-react with sulfonamide antibiotics and trigger an allergic reaction in susceptible individuals. In an educational context, understanding the pharmacological properties and potential adverse effects of selective COX-2 inhibitors is crucial for healthcare professionals in making informed decisions about their use in clinical practice. It is essential to weigh the benefits of these drugs in managing pain and inflammation against their potential risks, such as cardiovascular events, gastrointestinal complications, and allergic reactions. Healthcare providers must be vigilant in assessing patient history, comorbidities, and risk factors before prescribing selective COX-2 inhibitors to ensure patient safety and optimal therapeutic outcomes.

Correct Answer: A

Rationale: In this question, the correct answer is A) Colchicine in gout. Colchicine is known to cause adverse effects such as diarrhea and alopecia. Educational Rationale: - Colchicine is a medication used to treat gout, and its side effects are well documented, including gastrointestinal disturbances like diarrhea and hair loss (alopecia). - Paracetamol (B) is typically well-tolerated and is not associated with adverse effects such as diarrhea or alopecia. - Indomethacin (C) is a nonsteroidal anti-inflammatory drug (NSAID) commonly used in osteoarthritis, but its common side effects include gastrointestinal issues and ulcers rather than diarrhea and alopecia. - Aspirin (D) is often used for its antiplatelet effects in conditions like transient ischemic attacks, but it is not typically linked to diarrhea or alopecia. Educational Context: Understanding the adverse effects associated with specific drugs is crucial in pharmacology to make informed decisions about drug selection and management of side effects. This knowledge helps healthcare professionals provide safe and effective care to patients. By linking specific adverse effects to corresponding drugs, students can enhance their understanding of pharmacological principles and drug safety profiles.