If the coma was caused by thio- pental, which of the following drug reactions was most likely involved?

Correct Answer: D

Rationale: The coma caused by thio- pental is most likely due to a pseudoallergic reaction, as this type of reaction can lead to severe symptoms such as seizures and coma. Pseudoallergic reactions are non-immunologic reactions that can occur in individuals even without prior exposure to the drug, making them unpredictable and potentially life-threatening. In this case, the patient's history of acute intermittent porphyria may have contributed to the pseudoallergic reaction to thio- pental.

Correct Answer: B

Rationale: Lipid solubility of a drug is influenced by its pKa value. Since valproic acid has a pKa of 5, it would likely be lipid soluble at a pH of 7 in the duodenal lumen. The Henderson-Hasselbalch equation suggests that when the pH is higher than the pKa, the drug will predominantly be in its non-ionized, lipid-soluble form. In this case, the drug would be about 24% lipid soluble in the duodenal lumen, making choice B the correct answer.

Correct Answer: D

Rationale: The injected dose of cocaine can be calculated using the formula Dose = Cp * Vd, where Cp is the plasma concentration, and Vd is the volume of distribution. Given that the plasma level of cocaine was 0.75 mg/L, and the volume of distribution is about 130 L, the injected dose can be calculated as 0.75 * 130 = 97.5 mg, which is closest to option D.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.