Effects seen only with depolarizing blockade include all of the following EXCEPT:

Correct Answer: B

Rationale: The correct answer is B: A decrease in intraocular pressure. Depolarizing blockade, such as with succinylcholine, leads to sustained depolarization of the neuromuscular junction, causing muscle paralysis. This can result in hyperkalemia due to potassium release from muscles, emesis due to stimulation of chemoreceptors, and muscle pain due to fasciculations. Intraocular pressure is not affected by depolarizing blockade. Therefore, a decrease in intraocular pressure is not an effect seen with depolarizing blockade, making choice B the correct answer.

Correct Answer: A

Rationale: Rationale: Betaxolol is the correct answer as it is a beta1-selective antagonist with a long duration of action due to its lipophilic properties. It has minimal beta2 or intrinsic sympathomimetic activity, leading to prolonged effects on heart rate and blood pressure. Sotalol (B) is a non-selective beta-blocker with class III antiarrhythmic properties. Nadolol (C) is a non-selective beta-blocker with a long duration, but not beta1-selective. Metoprolol (D) is a beta1-selective antagonist but has a shorter duration compared to betaxolol.

Correct Answer: D

Rationale: Step 1: Zolpidem is a sedative-hypnotic medication used for treating insomnia by enhancing the effects of GABA in the brain. Step 2: Zolpidem causes significant effects on sleep patterns, not minor ones, making option A incorrect. Step 3: Zolpidem has a lower risk of tolerance and dependence compared to benzodiazepines, making option B correct. Step 4: Zolpidem primarily acts as a sedative and does not have significant muscle relaxing or anticonvulsant effects, making option C incorrect. Step 5: Combining the above points, option D is correct as it encompasses the accurate statements about zolpidem.

Correct Answer: B

Rationale: The correct answer is B: Valproate. Valproate is contraindicated in patients with hepatic disease because it can cause severe liver damage. Patients with a history of hepatic dysfunction are at higher risk of developing hepatotoxicity with valproate use. A: Lamotrigine is generally safe in patients with hepatic disease and does not have a significant impact on liver function. C: Carbamazepine can also be used cautiously in patients with hepatic disease, although dose adjustments may be necessary. D: Phenytoin is metabolized in the liver, but it is not as strongly associated with liver toxicity as valproate. Therefore, valproate is the correct answer due to its potential for severe hepatotoxicity in patients with hepatic disease or dysfunction.

Correct Answer: C

Rationale: The correct answer is C: Morphine. Morphine is a natural opioid analgesic that acts as an agonist at the mu-opioid receptors in the central nervous system, producing pain relief and sedation. It is derived from the opium poppy plant, making it a natural agonist. Meperidine (A) and Fentanyl (B) are synthetic opioids, while Naloxone (D) is an opioid antagonist used to reverse opioid overdose by blocking the effects of opioids. Therefore, the natural agonist among the options is Morphine.