Which of the following drugs most likely caused the patient's symptoms of abnormal growth of the breast?

Correct Answer: B

Rationale: The correct answer is B: Risperidone. Risperidone is an atypical antipsychotic known to cause side effects such as abnormal breast growth (gynecomastia) due to its effects on hormone levels. Haloperidol (A) is a typical antipsychotic with a lower likelihood of causing gynecomastia. Amitriptyline (C) is a tricyclic antidepressant that does not typically cause gynecomastia. Buspirone (D) is an anxiolytic medication that is not associated with gynecomastia. Therefore, based on the patient's symptoms, the most likely culprit is Risperidone due to its known side effect profile.

Correct Answer: D

Rationale: The correct answer is D: Chlorpromazine. The patient reported symptoms are likely extrapyramidal side effects, such as tremors, muscle rigidity, and akathisia, which are common with typical antipsychotics like chlorpromazine. Lithium (A) is used for bipolar disorder, not associated with these side effects. Amitriptyline (B) is a tricyclic antidepressant, known for sedation and anticholinergic effects. Fluoxetine (C) is a selective serotonin reuptake inhibitor, not known for causing extrapyramidal symptoms. Therefore, based on the symptoms described, chlorpromazine is the most likely culprit.

Correct Answer: A

Rationale: The correct answer is A: Amitriptyline. Metoclopramide interacts with amitriptyline by inhibiting its metabolism, leading to increased levels of amitriptyline in the body. This can result in adverse effects such as sedation, confusion, and potential serotonin syndrome. Explanation: 1. Metoclopramide is known to inhibit CYP2D6 enzyme, which is responsible for metabolizing amitriptyline. 2. Increased amitriptyline levels can lead to enhanced sedative effects and central nervous system depression. 3. The combination can also increase the risk of serotonin syndrome due to the additive serotonergic effects of both drugs. Summary: B: Lithium - Lithium does not have a significant metabolic interaction with metoclopramide. C: Zolpidem - Zolpidem is primarily metabolized by different enzymes and does not interact significantly with metoclopramide. D: Paroxetine - Although both

Correct Answer: C

Rationale: The correct answer is C: Insomnia. During the first days of lithium therapy, individuals are more likely to experience insomnia due to the stimulating effects of lithium on the central nervous system. This can disrupt sleep patterns and cause difficulty falling or staying asleep. Choice A (Constipation) is less likely to occur as lithium is not known to have a significant impact on gastrointestinal motility. Choice B (Weight loss) is also less likely as weight gain is a more common side effect of lithium therapy. Choice D (Hypertension) is not typically seen in the initial days of lithium therapy, as lithium is more commonly associated with long-term kidney-related issues leading to hypertension.

Correct Answer: B

Rationale: The correct answer is B: Norepinephrine. Norepinephrine is a neurotransmitter and a medication that can increase blood pressure by constricting blood vessels. Atomoxetine (A) is used to treat ADHD and does not typically cause high blood pressure. Phenylephrine (C) is a decongestant that can raise blood pressure temporarily. Guanfacine (D) is a medication used to lower blood pressure, so it is unlikely to be the cause of the patient's high blood pressure.