Use of gold compounds in rheumatoid arthritis is beneficial in

Correct Answer: A

Rationale: The correct answer is A) Early active disease not responding to NSAIDs. Gold compounds, such as auranofin and aurothiomalate, have been used in the treatment of rheumatoid arthritis. In early active disease not responding to NSAIDs, gold compounds have shown efficacy in modifying the disease progression and reducing joint damage. Option B) Mild disease is incorrect because gold compounds are typically reserved for cases of more severe or active disease that are not responding to other treatments like NSAIDs. Option C) Advanced disease is also incorrect as gold compounds are not typically recommended for use in advanced stages of rheumatoid arthritis where other more potent treatments may be necessary. Option D) As first-line therapy is incorrect because gold compounds are usually considered after other conventional treatments have been tried and found ineffective. In an educational context, understanding the appropriate use of gold compounds in rheumatoid arthritis is crucial for healthcare providers involved in managing patients with this condition. It is important to know the indications and limitations of different pharmacological treatments to provide optimal care for patients with rheumatoid arthritis.

Correct Answer: D

Rationale: In this question, the correct answer is D) Reserpine. Reserpine is a drug that decreases the functional activities of several CNS neurotransmitters, including dopamine, norepinephrine, and serotonin. This action is due to its ability to deplete these neurotransmitters from storage vesicles, leading to reduced neurotransmission. At high doses, reserpine can cause parkinsonism-like extrapyramidal dysfunction due to the depletion of dopamine. Now, let's analyze why the other options are incorrect: A) Amphetamine: Amphetamine increases the release of dopamine, norepinephrine, and serotonin into the synaptic cleft, leading to enhanced neurotransmission. This is the opposite effect of what is described in the question. B) Baclofen: Baclofen is a GABA receptor agonist primarily used as a muscle relaxant. It does not have the same mechanism of action as described in the question. C) Diazepam: Diazepam is a benzodiazepine that enhances the inhibitory effects of GABA in the CNS. It does not decrease the functional activities of dopamine, norepinephrine, and serotonin. Educational context: Understanding the pharmacology of CNS drugs is crucial for healthcare professionals to make informed decisions when prescribing medications for various neurological conditions. Knowledge of how different drugs modulate neurotransmitter systems helps in predicting their effects and potential side effects, leading to better patient outcomes. It is essential for students and professionals in the healthcare field to grasp these concepts to provide safe and effective care to patients with CNS disorders.

Correct Answer: A

Rationale: In patients using sedative-hypnotic drugs, the most frequent drug interaction is an additive CNS depression (Option A). This occurs because sedative-hypnotics already depress the central nervous system (CNS), and when combined with other CNS depressants like alcohol or opioids, the effects can be potentiated, leading to excessive sedation, respiratory depression, and even coma. Option B, antagonism of sedative or hypnotic actions, is less likely to occur because drug interactions typically lead to additive effects rather than cancelling each other out. Option C, competition for plasma protein binding, is a common type of drug interaction but is not the most frequent one seen with sedative-hypnotics. Option D, induction of liver drug-metabolizing enzymes, can lead to decreased levels of sedative-hypnotics in the body, but it is not the most common interaction observed with these drugs. Educationally, understanding drug interactions is crucial for healthcare professionals to ensure safe and effective medication management. In the case of CNS drugs, the potential for additive CNS depression highlights the importance of cautious prescribing, monitoring for signs of sedation, and educating patients on the risks of combining sedative-hypnotics with other CNS depressants. This knowledge is vital for pharmacists, nurses, and physicians to prevent adverse drug events and optimize patient care.

Correct Answer: C

Rationale: In the context of pharmacology of CNS drugs, the question about withdrawal risk is crucial for understanding the management of patients with seizure disorders. The correct answer is C) Ethosuximide. Ethosuximide is the least likely to increase seizure frequency upon withdrawal compared to the other options. This is because ethosuximide is primarily used in absence seizures and does not have significant effects on other types of seizures. Therefore, its withdrawal is less likely to lead to rebound seizures. Clonazepam (Option A) and Diazepam (Option B) are benzodiazepines commonly used for seizure control. Abrupt withdrawal of these drugs can lead to rebound seizures due to their potent antiseizure effects and potential for dependence. Phenobarbital (Option D) is a barbiturate with a long half-life and potent antiseizure properties. Abrupt discontinuation of phenobarbital can result in a withdrawal syndrome characterized by an increased risk of seizures. Educationally, understanding the withdrawal risks of antiseizure drugs is essential for healthcare providers managing patients with seizure disorders. It emphasizes the importance of gradual tapering of these medications to prevent rebound seizures and withdrawal symptoms. In the context of patient care, this knowledge can help in making informed decisions regarding drug therapy adjustments to ensure the safety and well-being of individuals with seizure disorders.

Correct Answer: D

Rationale: The correct answer is D) Propofol. Propofol is a preferred intravenous anesthetic for many surgical procedures due to its rapid onset and offset of action, resulting in a smoother and quicker recovery compared to other agents. Postoperative nausea and vomiting (PONV) are less common with propofol, making it a favorable choice for patients at risk for these complications. Additionally, propofol allows for faster awakening and earlier ambulation of patients, promoting a quicker recovery and discharge from the recovery room. A) Enflurane is a volatile anesthetic associated with a higher incidence of PONV compared to propofol. It is not specifically known for promoting early ambulation. B) Ketamine is a dissociative anesthetic that can cause emergence reactions, including hallucinations and delirium, which may delay ambulation. It is not typically used for general anesthesia when rapid recovery and early ambulation are desired. C) Morphine is an opioid analgesic commonly used for pain management postoperatively but is not an anesthetic agent. While it can contribute to PONV, its effects on ambulation are more related to sedation and respiratory depression rather than facilitating early mobility. In an educational context, understanding the pharmacology of CNS drugs is crucial for healthcare providers involved in anesthesia and perioperative care. Knowing the properties of different anesthetic agents, their side effect profiles, and how they impact postoperative outcomes like PONV and ambulation can help in making informed decisions to optimize patient care and recovery.