Tick the drug that can induce nausea, diarrhea, abdominal pain and rhinitis:

Correct Answer: D

Rationale: Step-by-step rationale: 1. Saquinavir is a protease inhibitor used to treat HIV/AIDS. 2. Protease inhibitors can cause gastrointestinal side effects like nausea, diarrhea, abdominal pain. 3. Saquinavir is known to induce rhinitis as a common side effect. 4. Options A, B, and C are antiviral drugs but do not typically cause these specific side effects. Summary: Saquinavir is the correct answer as it is a protease inhibitor known to induce gastrointestinal symptoms and rhinitis. The other options are antiviral drugs that do not have these specific side effects.

Correct Answer: D

Rationale: The correct answer is D, Triamterene. Triamterene is a potassium-sparing diuretic, which can lead to hyperkalemia. Patients with liver cirrhosis often have impaired liver function, leading to decreased potassium excretion. Hyperkalemia can worsen in these patients and can be dangerous. Mannitol (A) is an osmotic diuretic, Hydrochlorothiazide (B) is a thiazide diuretic, and Ethacrynic acid (C) is a loop diuretic, all of which can be used in patients with liver cirrhosis and ascites, but Triamterene should be avoided due to the risk of hyperkalemia.

Correct Answer: A

Rationale: Inhibition of carbonic anhydrase results in the abolition of NaHCO3 reabsorption in the proximal tubule because carbonic anhydrase is an enzyme necessary for the conversion of carbon dioxide and water to bicarbonate and hydrogen ions. By inhibiting this enzyme, the conversion process is disrupted, leading to decreased bicarbonate reabsorption. Option B, which suggests enhanced NaHCO3 reabsorption in the proximal tubule, is incorrect because inhibition of carbonic anhydrase would actually decrease this reabsorption. Option C, enhanced NaHCO3 secretion in the distal tubule, is also incorrect as the primary impact of carbonic anhydrase inhibition is on the proximal tubule, not the distal tubule. Understanding the effects of carbonic anhydrase inhibition is crucial in pharmacology, especially when considering medications like acetazolamide that act by inhibiting this enzyme to decrease bicarbonate reabsorption. This knowledge is vital for healthcare professionals in managing conditions such as glaucoma, altitude sickness, and metabolic alkalosis. Understanding these concepts can help ensure safe and effective patient care.

Correct Answer: D

Rationale: In the case of a patient with acute myocardial infarction and left ventricular failure, the most suitable route/method of administration for glyceryl trinitrate is a slow intravenous infusion (Option D). The rationale behind choosing slow intravenous infusion is that it provides a controlled and gradual delivery of the medication, allowing for a more sustained effect on the patient's condition. This is crucial in managing acute heart conditions like myocardial infarction, where precise dosing and continuous monitoring are essential. Sublingual administration (Option A) is not ideal in this situation because the patient is in the intensive care unit with a critical condition, and sublingual administration may not provide the rapid and consistent absorption needed for immediate effect. Oral administration (Option B) is also not preferred due to the delayed onset of action and potential variability in absorption, which is not suitable for a patient requiring prompt and precise treatment. Intravenous bolus injection (Option C) may lead to rapid fluctuations in blood levels of the medication, potentially causing adverse effects or inadequate therapeutic response in this critical condition. In an educational context, understanding the rationale behind the choice of medication administration route is crucial for healthcare professionals to make informed decisions in clinical practice. It highlights the importance of patient-specific factors, drug pharmacokinetics, and the need for individualized treatment strategies in managing cardiovascular emergencies.

Correct Answer: A

Rationale: In the treatment of cardiac shock, the drug of choice is Dopamine. Dopamine is a naturally occurring catecholamine that acts on adrenergic and dopaminergic receptors. In cardiac shock, dopamine is used to increase cardiac output by enhancing myocardial contractility and improving renal perfusion. Propranolol (Option B) is a beta-blocker that would not be appropriate in the treatment of cardiac shock as it decreases heart rate and contractility, which can worsen the condition. Phenoxybenzamine (Option C) is an alpha-blocker used in conditions like pheochromocytoma, not for cardiac shock. Metaraminol (Option D) is a sympathomimetic amine used for treating hypotension, but not specifically for cardiac shock. In an educational context, understanding the rationale behind the choice of dopamine in cardiac shock is crucial for healthcare professionals, especially those involved in emergency medicine or critical care. Knowing the pharmacological effects of dopamine on cardiac function and hemodynamics helps in making informed decisions during emergencies. It also highlights the importance of selecting the most appropriate drug based on the pathophysiology of the condition to achieve the best patient outcomes.