Which of the following drugs is not effective in acute congestive glaucoma?

Correct Answer: C

Rationale: In this question, the correct answer is C) Timolol. Timolol is a beta-blocker that is primarily used to lower intraocular pressure in chronic open-angle glaucoma, not in acute congestive glaucoma. Acetazolamide (A) is a carbonic anhydrase inhibitor that can be effective in reducing intraocular pressure in acute congestive glaucoma by decreasing aqueous humor production. Pilocarpine (B) is a cholinergic agonist that can help constrict the pupil and pull the iris away from the trabecular meshwork, aiding in the drainage of aqueous humor in acute glaucoma. Mannitol (D) is an osmotic diuretic that can reduce intraocular pressure by drawing fluid out of the eye tissues. Educationally, understanding the mechanisms of action of different drugs used in the treatment of glaucoma is crucial for nursing practice. Recognizing the specific indications for each drug and their effectiveness in different types of glaucoma is essential for providing safe and effective care to patients with eye conditions. This knowledge helps nurses make informed decisions about drug administration and monitor for desired therapeutic effects or potential adverse reactions.

Correct Answer: A

Rationale: In this question, the correct answer is A) Morphine, which has very low protein binding. Protein binding refers to the extent to which a drug binds to proteins in the blood. Morphine has a protein binding of around 35%, which is considered low compared to other opioids. Meperidine, option B, has a protein binding of around 70-80%, making it a poor choice for the answer. Propoxyphene, option C, and Codeine, option D, also have higher protein binding percentages compared to Morphine, making them incorrect choices for this question. Educationally, understanding the protein binding of drugs is crucial as it influences their distribution, metabolism, and elimination in the body. For healthcare professionals, knowing the protein binding characteristics of opioids is essential for dosing, predicting drug-drug interactions, and understanding potential side effects related to drug displacement from protein-binding sites. This knowledge is particularly important in clinical settings where precise drug administration is critical for patient safety and optimal outcomes.

Correct Answer: D

Rationale: In this question, the correct answer is D) Desipramine. Desipramine is a tricyclic antidepressant that is known to have the least anticholinergic effects and sedation among the options provided. Desipramine is a secondary amine tricyclic antidepressant that has a lower affinity for muscarinic receptors compared to other tricyclic antidepressants like Amitriptyline, Clomipramine, and Amoxapine. This lower affinity results in decreased anticholinergic side effects such as dry mouth, constipation, blurred vision, and cognitive impairment. Amitriptyline (Option A) is known for its strong anticholinergic effects and sedation, making it less favorable in patients who are sensitive to these side effects. Clomipramine (Option B) and Amoxapine (Option C) also have significant anticholinergic effects and sedation compared to Desipramine. From an educational standpoint, understanding the differences in side effect profiles of tricyclic antidepressants is crucial for nurses and healthcare professionals when selecting the most appropriate medication for patients with depression. Desipramine's lower anticholinergic effects make it a preferred choice in patients who are prone to these adverse reactions, highlighting the importance of individualized treatment plans based on patient characteristics and medication profiles.

Correct Answer: C

Rationale: Zolpidem is used as a sedative and hypnotic drug, making option C the correct answer. Zolpidem is a medication commonly prescribed for the short-term treatment of insomnia. It works by slowing down brain activity to help induce sleep. Option A, anticonvulsant drug, is incorrect because zolpidem is not used to treat seizures or epilepsy. Option B, anti-anxiety drug, is incorrect because zolpidem is not typically used to treat anxiety disorders. Option D, myorelaxant drug, is incorrect because zolpidem does not have significant muscle relaxant properties. In an educational context, understanding the correct use of zolpidem is important for nursing students and healthcare professionals who may encounter patients with sleep disturbances. Knowing the correct indications for medications like zolpidem ensures safe and effective patient care. Additionally, understanding the differences between various drug classes helps students develop critical thinking skills when making clinical decisions.

Correct Answer: B

Rationale: The correct answer is B) Pseudo cholinesterase. Ester type local anesthetics, such as procaine and chloroprocaine, are metabolized by pseudocholinesterase in the plasma. Pseudocholinesterase is an enzyme found in the blood that is responsible for the hydrolysis of certain ester-type drugs, including local anesthetics. Option A) True cholinesterase is not responsible for the hydrolysis of ester-type local anesthetics. True cholinesterase is primarily involved in the breakdown of acetylcholine in the neuromuscular junction. Option C) Liver microsomal enzymes are not involved in the hydrolysis of ester-type local anesthetics. These enzymes are primarily responsible for the metabolism of many drugs, toxins, and endogenous substances in the liver. Option D) All of the above is incorrect because the correct enzyme responsible for hydrolyzing ester-type local anesthetics is pseudocholinesterase, not true cholinesterase or liver microsomal enzymes. Understanding the metabolism of local anesthetics is crucial for healthcare professionals, especially those administering these drugs in clinical practice. Knowledge of the specific enzymes involved in the metabolism of ester-type local anesthetics can help prevent adverse reactions and ensure the safe and effective use of these medications in patient care.