Strategies prescribers can use to prevent misuse of controlled prescription drugs include:

Correct Answer: D

Rationale: Choice D is correct because all listed strategies—screening for dependency, setting firm limits, and refusing inappropriate requests—help prevent misuse of controlled drugs by identifying risks and maintaining control. Choice A is incorrect alone as screening is just one tool. Choice B is wrong by itself because limits need broader support. Choice C is incorrect solo since refusal must be part of a comprehensive approach.

Correct Answer: D

Rationale: Choice D is correct because lower doses (less toxicity), avoiding high-risk drugs (e.g., Beers list), and regular reviews (catch interactions) all reduce ADEs in the elderly, per guidelines. Choice A is incorrect alone as it's one strategy. Choice B is wrong by itself because avoidance is just part. Choice C is incorrect solo since reviews are only one approach.

Correct Answer: A

Rationale: Choice A is correct because sedating drugs (e.g., opioids) in breast milk can cause infant drowsiness or respiratory depression, a primary risk. Choice B is incorrect as no drugs typically ‘stimulate growth' in this context—growth is natural. Choice C is wrong because acetaminophen is safe, with minimal risk. Choice D is incorrect since only A is a significant concern.

Correct Answer: D

Rationale: Choice D is correct because off-label use treats unmet needs (e.g., rare diseases), may be cheaper (existing drugs), and leverages known profiles, per clinical benefits. Choice A is incorrect alone as it's one advantage. Choice B is wrong by itself because cost is just part. Choice C is incorrect solo since familiarity is only one benefit.

Correct Answer: C

Rationale: The correct answer is C because generic names like acetaminophen should be used to avoid confusion and overdose, as it has many trade names. Choice A is incorrect as APAP is an abbreviation, not patient-friendly. Choice B is wrong since Tylenol is a brand name. Choice D is inaccurate as not all OTC products are equivalent.

Correct Answer: A

Rationale: Choice A is correct because hypoalbuminemia lowers albumin levels, which bind drugs in plasma; this alters distribution to tissues, potentially increasing free drug concentrations and affecting efficacy or toxicity. Choice B is incorrect as solubility relates to absorption, not albumin binding. Choice C is wrong because less albumin means more free drug, not less, due to reduced binding. Choice D is incorrect since albumin-bound drugs are less readily excreted; lower binding prolongs drug presence in circulation.

Correct Answer: C

Rationale: Choice C is correct because women generally have a higher percentage of body fat, affecting the volume of distribution for lipophilic drugs, a key pharmacokinetic difference. Choice A is incorrect as body temperature differences are minimal and don't significantly alter pharmacokinetics. Choice B is wrong because men, not women, typically have greater muscle mass. Choice D is incorrect since subjective factors aren't proven pharmacokinetic variables.

Correct Answer: B

Rationale: Choice B is correct because St John's wort induces CYP3A4 and affects serotonin, risking reduced antidepressant efficacy or serotonin syndrome, so it's to be avoided. Choice A is incorrect as ginkgo biloba doesn't significantly interact with antidepressants. Choice C is wrong because valerian root's sedative effect is minor and not a major concern. Choice D is incorrect since only St John's wort poses a substantial risk.

Correct Answer: B

Rationale: Choice B is correct because CYP2D6 ultrarapid metabolizers convert codeine to morphine too quickly, risking overdose and toxicity, so it should be avoided. Choice A is incorrect as acetaminophen's metabolism isn't significantly CYP2D6-dependent, posing less risk. Choice C is wrong because ibuprofen isn't metabolized by CYP2D6, so ultrarapid status is irrelevant. Choice D is incorrect since only codeine poses a specific danger here.