We want to prescribe scopolamine, as a transdermal drug delivery system (skin patch), for a patient who will be leaving for an expensive cruise and is very susceptible to motion sickness. For which of the following co-morbidities is scopolamine contraindicated?

Correct Answer: A

Rationale: The correct answer is A: Angle-closure (narrow-angle) glaucoma. Scopolamine, an anticholinergic medication, can worsen angle-closure glaucoma by causing pupil dilation leading to increased intraocular pressure. This can result in a sudden and severe increase in eye pressure, leading to potential vision loss. Therefore, it is contraindicated in patients with narrow-angle glaucoma. B: Bradycardia is not a contraindication for scopolamine use as it may actually help in treating motion sickness. C: History of shellfish allergies is not a contraindication for scopolamine as the medication is not derived from shellfish and is safe for patients with this allergy. D: Resting blood pressure of 112/70 is not a contraindication for scopolamine use as it falls within the normal range and should not pose any significant risk.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: D

Rationale: Noradrenaline acts on alpha receptors in the cardiovascular system, leading to increased systolic and diastolic blood pressure. It also causes reflex bradycardia by activating baroreceptors. However, noradrenaline does not directly constrict coronary blood vessels, as it primarily acts on alpha receptors and not on coronary vessels. This lack of direct effect on coronary blood vessels is why option D is the correct answer.

Correct Answer: D

Rationale: Certainly! Atropine is an anticholinergic drug that works by blocking the action of acetylcholine. Xerostomia (dry mouth) is a symptom caused by decreased salivary gland activity, so using atropine would exacerbate this condition. In contrast, atropine is used in pre-anesthetic medication to reduce secretions, in organic phosphate poisoning to counteract the cholinergic effects, and in intestinal colic to relax smooth muscles. Therefore, the correct answer is D because atropine would worsen dry mouth.

Correct Answer: D

Rationale: The correct answer is D: Alpha 1 receptor stimulation releases IP3 and DAG. When alpha 1 receptors are stimulated by sympathomimetics, they activate G-proteins which then stimulate phospholipase C. Phospholipase C cleaves phosphatidylinositol 4,5-bisphosphate (PIP2) into inositol trisphosphate (IP3) and diacylglycerol (DAG). IP3 triggers the release of calcium from intracellular stores, leading to smooth muscle contraction, while DAG activates protein kinase C to initiate various cellular responses. Choices A, B, and C are incorrect because beta receptor stimulation increases cAMP, alpha 2 receptor stimulation inhibits adenyl cyclase leading to decreased cAMP levels, and alpha 2 receptor stimulation does not increase cAMP.