Meperidine hydrochloride (Demerol) is given to a client who is experiencing post-operative pain. Which of the following are the side effects of the medication, except?

Correct Answer: B

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic commonly used for post-operative pain management. The common side effects of meperidine include tremors, sweating, and dizziness. Diarrhea is not a common side effect associated with meperidine use. Opioid analgesics like meperidine more commonly cause constipation rather than diarrhea. Therefore, choice B is the correct answer as the side effect of diarrhea is not typically seen with meperidine administration.

Correct Answer: B

Rationale: Metformin is a first-line medication for the treatment of type 2 diabetes. Its primary pharmacological action is to decrease hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis in the liver. This helps to lower blood glucose levels. Metformin also increases insulin sensitivity in peripheral tissues like muscle and fat, allowing tissues to better respond to insulin and take up glucose from the blood. This dual mechanism of action makes metformin an effective medication for managing blood glucose levels in patients with type 2 diabetes.

Correct Answer: A

Rationale: Warfarin is an anticoagulant medication that works by inhibiting the action of vitamin K, reducing blood clotting. In cases of Warfarin overdose or excessive anticoagulation resulting in bleeding complications, the antidote is vitamin K. Vitamin K helps the liver produce clotting factors, which can counteract the effects of Warfarin and restore normal blood clotting. Other options such as Naloxone, Digibind, and Flumazenil are antidotes used for specific situations like opioid overdose, digoxin toxicity, and benzodiazepine overdose, respectively, and are not relevant for Warfarin antidote.

Correct Answer: B

Rationale: The main difference between ester group local anesthetics and amide group local anesthetics lies in the way they are metabolized in the body. Esters are metabolized in the plasma by the enzyme pseudocholinesterase, while amides are metabolized in the liver. Pseudocholinesterase hydrolyzes esters into inactive metabolites, which are then excreted mainly by the kidneys. On the other hand, amides undergo hepatic metabolism by the cytochrome P450 enzyme system before being excreted by the kidneys. This key metabolic difference between esters and amides impacts their pharmacokinetics, including onset of action, duration of effect, and potential for allergic reactions.

Correct Answer: D

Rationale: Terfenadine is a second-generation antihistamine, but it is not an H1 receptor antagonist like the other options listed. Terfenadine was once used for the treatment of allergic conditions, but it is known for its potential to cause cardiac side effects due to its interaction with other medications and prolongation of the QT interval. Consequently, terfenadine has been largely replaced by newer, safer antihistamines. The rest of the options listed (chlorpheniramine, promethazine, cimetidine, and diphenhydramine) are all H1 receptor antagonists commonly used to block the action of histamine and relieve symptoms of allergies.