Diazoxide is an effective hypotensive, but it is not used long-term because

Correct Answer: D

Rationale: Diazoxide has multiple adverse effects including hyperglycemia fluid retention and hyperuricemia.

Correct Answer: C

Rationale: Acetylsalicylic acid (aspirin) inhibits COX enzymes, reducing prostaglandin synthesis (choice D), yielding analgesic (choice A) and antipyretic (choice B) effects by decreasing pain mediators and hypothalamic heat regulation, respectively. However, it inhibits, not promotes, platelet aggregation (choice C) by blocking thromboxane A2 production, a pro-aggregatory prostaglandin, making it antiplatelet, used in cardiovascular prophylaxis. Promotion of aggregation would contradict its mechanism. This exception tests understanding of aspirin's unique antiplatelet action among NSAIDs, critical for its clinical applications.

Correct Answer: B

Rationale: The drug causing diarrhea in the woman is most likely paroxetine, which increases serotonergic activity in the enteric nervous system, leading to the adverse effect of diarrhea.

Correct Answer: C

Rationale: Insomnia is a common early adverse effect of lithium therapy due to its impact on sleep patterns. Patients may experience difficulty falling asleep or staying asleep during the initial days of treatment. This side effect typically resolves as the body adjusts to the medication. Constipation, weight loss, hypertension, and edema are less commonly associated with lithium therapy in the early stages.

Correct Answer: D

Rationale: The recently approved drug that acts with a novel mechanism of action, a noncompetitive blockade of AMPA receptors on brain neurons, is Perampanel. Given that the patient had poorly controlled seizures with valproic acid, adding Perampanel would provide a different mechanism of action to improve seizure control.