Select the analgesic that acts via opioid and spinal monoaminergic mechanisms

Correct Answer: A

Rationale: Tramadol has dual mechanisms, affecting opioid receptors and inhibiting serotonin/norepinephrine reuptake.

Correct Answer: A

Rationale: DES, a synthetic estrogen, causes deep vein thrombosis (choice A), feminization of male offspring (choice B), and miscarriages (choice C) in pregnancy, linked to historical congenital anomalies (e.g., vaginal adenocarcinoma). Virilization of female offspring (choice D) isn't reported; DES mimics estrogen, not androgens. This exception highlights its teratogenic risks, banning its use in pregnancy.

Correct Answer: A

Rationale: Tubocurarine is a non-depolarizing muscle relaxant that can cause histamine release, leading to bronchoconstriction. In a patient with chronic obstructive pulmonary disease and a history of smoking, using tubocurarine could exacerbate respiratory issues, making it contraindicated in this case.

Correct Answer: B

Rationale: Bicuculline is a competitive antagonist of GABA-A receptors, blocking inhibitory neurotransmission and potentially inducing seizures.

Correct Answer: C

Rationale: Interferons are involved in antiviral defense and immune modulation, not acute inflammation.