Which medication is a glutamate receptor antagonist that can be used in combination with an acetylcholinesterase inhibitor to manage the symptoms of Alzheimer's disease?

Correct Answer: D

Rationale: Memantine, an NMDA glutamate receptor antagonist, manages Alzheimer's by reducing excitotoxicity from excessive glutamate, which contributes to neuronal damage in later stages. It complements acetylcholinesterase inhibitors (e.g., donepezil), which boost cholinergic function for memory, by targeting a different pathway, slowing progression and improving behavior. Rivastigmine and donepezil are acetylcholinesterase inhibitors, not glutamate antagonists. Ropinirole, a dopamine agonist, treats Parkinson's. Fluoxetine, an SSRI, addresses depression. Memantine's unique glutamate modulation, combined with cholinergic enhancement, offers a dual approach, supported by evidence for moderate-to-severe Alzheimer's management.

Correct Answer: A

Rationale: Aspirin's antiplatelet effect risks GI bleeding, causing dark stools , a serious adverse effect needing urgent assessment. Nasal stuffiness , photophobia , and nocturia aren't typical. A signals potential hemorrhage, making it the correct adverse effect.

Correct Answer: B

Rationale: Ciprofloxacin, a fluoroquinolone, treats UTIs but causes photosensitivity, risking severe sunburn. Avoiding sun exposure prevents this, a key instruction for safety. Milk reduces absorption via calcium binding, lowering efficacy. Taking it PRN risks incomplete treatment and resistance. Doubling doses courts toxicity. Sun avoidance aligns with ciprofloxacin's side effect profile, critical for outpatient adherence where sun exposure is common. This teaching prevents avoidable harm, distinguishing it from administration errors, making B the essential instruction.

Correct Answer: A

Rationale: Fluoxetine, an SSRI, is a common cause of serotonin syndrome when used alone or in combination with other serotonergic agents.