Gold sodium thiomalate is prescribed to a client with rheumatoid arthritis. Which of the following side effects indicates an overdose of the medication?

Correct Answer: D

Rationale: Rationale: Gold sodium thiomalate is a disease-modifying antirheumatic drug (DMARD) used in the treatment of rheumatoid arthritis. The correct answer is option D) Metallic taste, indicating an overdose of the medication. Excessive dosing of gold sodium thiomalate can lead to a metallic taste in the mouth, a common side effect of toxicity. This adverse reaction is a result of the gold compound accumulating in the body beyond therapeutic levels. Option A) Flushing is a common side effect of gold therapy but is not specific to an overdose. It is often seen with initial doses and tends to diminish over time. Option B) Dizziness is a general side effect of many medications, including gold sodium thiomalate, but it is not a definitive sign of overdose. Option C) Joint pain is a symptom of rheumatoid arthritis itself and would not specifically indicate an overdose of gold sodium thiomalate. Educationally, it is crucial for healthcare providers to understand the side effects and toxicities associated with medications like gold sodium thiomalate to ensure safe and effective patient care. Monitoring for signs of overdose, such as a metallic taste, is essential in managing patients receiving this drug.

Correct Answer: B

Rationale: Rifabutin, metabolized by CYP3A4, is affected by inhibitors. Zidovudine, enfuvirtide, and nevirapine don't strongly inhibit CYP3A4. St John's wort induces it, lowering levels. Ritonavir, a potent CYP3A4 inhibitor, significantly slows rifabutin metabolism, raising levels and toxicity risk (e.g., uveitis), the most impactful. This interaction requires dose adjustment, critical in HIV-TB co-treatment.

Correct Answer: D

Rationale: Phenytoin controls status epilepticus via anticonvulsant action, not sedation, so that's false. It precipitates in dextrose, only saline-compatible, making that false. Diazepam's effect is short-lived, not long-lasting, so that's incorrect. Phenobarbitone commonly causes respiratory depression, a true statement, due to CNS suppression. Phenytoin's rate is 50 mg/min max. This side effect limits phenobarbitone's use, requiring ventilatory support in status management.

Correct Answer: C

Rationale: Reading OTC labels and seeking clarification from a doctor if unclear ensures safe use, reflecting effective education on responsibility. Always calling the doctor is overly cautious-OTC drugs are for self-management. Pharmacists help, but label-reading is primary. Assuming OTC safety ignores risks like ibuprofen's bleeding potential. Label focus empowers clients, balancing autonomy with safety, a key learning outcome.

Correct Answer: D

Rationale: In pharmacology, a dose-response relationship curve illustrates the relationship between the dose of a drug administered and the response elicited in the body. The plateau phase on this curve represents the point at which the maximum response of the drug is achieved, and further increases in dosage do not lead to additional effects. Option D, marking the location of the beginning of the plateau phase on the dose-response curve, is correct because it corresponds to the horizontal area at the top of the curve. This area indicates that the maximum response has been achieved, and no further increase in response is seen even with higher doses of the drug. Option A, at the beginning of the curve, is incorrect because this point represents the initiation of the dose-response relationship, not the plateau phase. Option B, at the area where the curve moves upward, is also incorrect as this denotes the ascending portion of the curve where the response is increasing with increasing doses. Option C, halfway up the upstroke of the curve, is incorrect because it falls within the ascending phase of the curve, not at the plateau phase. Educationally, understanding the dose-response relationship is crucial for healthcare professionals to optimize drug therapy. Recognizing the plateau phase is essential for determining the appropriate dosage of a drug to achieve the desired therapeutic effect without risking toxicity. This knowledge helps in clinical decision-making and prescribing practices to ensure safe and effective patient care.