Sertraline (Zoloft) has been prescribed for a patient with symptoms of major depression. Which factor was probably most important in the physician's decision to use an SSRI?

Correct Answer: A

Rationale: In the context of pharmacology, particularly in the treatment of major depression, the physician's decision to prescribe Sertraline (Zoloft), an SSRI, is most likely influenced by the drug's good side-effect profile. SSRIs are commonly preferred in the treatment of depression due to their favorable side-effect profile compared to older antidepressants like tricyclics. This class of drugs is associated with fewer anticholinergic effects, sedation, and cardiovascular complications, making them safer and better tolerated by patients. Regarding the other options: - Less expense for the patient (Option B) may be a consideration in some cases, but when selecting a medication for a serious condition like major depression, efficacy and safety usually take precedence over cost. - Increase in medication compliance (Option C) is important but not the primary reason for choosing an SSRI. While adherence to treatment is crucial, the choice of an SSRI is more about its efficacy and tolerability. - Rapid rate of absorption from the GI tract (Option D) is not the primary factor in selecting an SSRI for depression. While absorption rate can be important for some drugs, in the case of SSRIs, the focus is more on their mechanism of action and side-effect profile. In an educational context, understanding the rationale behind drug selection in the treatment of specific conditions helps students grasp the importance of considering factors such as efficacy, safety, and tolerability when prescribing medications. This knowledge is essential for healthcare professionals to make informed decisions that optimize patient outcomes and minimize risks.

Correct Answer: A

Rationale: The correct answer is A) having a goal of incremental progress for the many instead of spectacular progress for the few. This is because the policy of harm reduction aims to reduce the negative consequences associated with drug use by implementing practical strategies that focus on minimizing harm rather than solely focusing on complete abstinence. Option B) having as its paramount object the reduction of drug consumption is incorrect because while reducing drug consumption may be a part of harm reduction, it is not the sole focus. Harm reduction recognizes that complete elimination of drug use may not be immediately achievable and aims to reduce harm in a pragmatic and achievable manner. Option C) utopian in its belief that drug-related harms can be eliminated by legalizing drugs is incorrect because harm reduction strategies do not necessarily advocate for the legalization of drugs. Instead, they focus on reducing the negative consequences of drug use through realistic and evidence-based approaches. Option D) considering addiction treatment programs as essential to reducing demand for drugs is incorrect because while addiction treatment is important in addressing substance use disorders, it is not the sole focus of harm reduction. Harm reduction encompasses a broader range of strategies including needle exchange programs, safe consumption sites, and education on safer drug use practices. In an educational context, understanding the principles of harm reduction is crucial for healthcare professionals, especially those working in the field of pharmacology. By recognizing the importance of harm reduction strategies, professionals can provide more comprehensive care to individuals struggling with substance use disorders and contribute to public health efforts aimed at reducing the negative impacts of drug use on individuals and communities.

Correct Answer: B

Rationale: This question requires the application of knowledge about selective serotonin reuptake inhibitors (SSRIs) to a specific plan for medication education. To reduce nausea, the patient should be advised to take the medicine with meals. When teaching patients who are taking tricyclic antidepressants (TCAs), one must emphasize that patients should dangle their legs over the bed and change positions slowly to prevent postural hypotension. It is also advisable for patients to increase fluids, exercise, and roughage intake to prevent the anticholinergic effects of antidepressants. Foods that contain tyramine (e.g., Chianti, nuts, cheese) are prohibited when patients are taking monoamine oxidase inhibitors (MAOIs). The primary synaptic activity for SSRIs is to inhibit the reuptake of 5-HT. The possible clinical effects of 5-HT include the following: gastrointestinal (GI) disturbances and sexual dysfunction. Fluoxetine hydrochloride (Prozac), an SSRI that is usually administered in the morning to reduce the potential of a side-effect profile that is 2+ for insomnia/agitation, also demonstrates a 3+ for GI disturbances.

Correct Answer: C

Rationale: In pharmacology, particularly when discussing psychotropic drugs, understanding their mechanism of action is crucial for safe and effective medication administration. In the context of the client's question on how psychotropic drugs work, the correct answer is C) Neurotransmitters. Neurotransmitters are chemical messengers that transmit signals across synapses in the nervous system. Psychotropic drugs, such as antidepressants, antipsychotics, and anxiolytics, exert their therapeutic effects by modulating the levels of neurotransmitters like serotonin, dopamine, and norepinephrine. By altering the balance of these neurotransmitters in the brain, psychotropic drugs can help regulate mood, cognition, and behavior in individuals with mental health disorders. Regarding why the other options are incorrect: A) The cerebellum is primarily involved in coordinating voluntary movements and balance, not the primary target for psychotropic drugs. B) Dendrites are extensions of neurons that receive signals, but they are not the main site of action for psychotropic drugs. D) The peripheral nervous system controls voluntary movements and autonomic functions but is not directly targeted by psychotropic drugs that primarily act within the central nervous system. Educationally, this question highlights the importance of understanding the specific targets of pharmacological agents and how they interact with the body to produce therapeutic effects. It reinforces the concept that psychotropic drugs exert their influence at the neurotransmitter level, underscoring the need for nurses to have a solid grasp of pharmacology to provide accurate patient education and safe medication management.

Correct Answer: B

Rationale: Flumazenil (Romazicon), a benzodiazepine antidote, can be used to acutely reverse the sedative effects of benzodiazepines. Hemodialysis is not useful for benzodiazepine overdose, and naloxone is used for opioid overdose, not benzodiazepine overdose. Intubation and mechanical ventilation are not appropriate because the patient is still responsive and breathing on his own.