Which of the following drugs was most likely prescribed for the patient with dull bone pain?

Correct Answer: A

Rationale: Fentanyl is a potent opioid analgesic that is often used for severe pain, including cancer-related pain. In this case, the patient's pain was initially relieved by ibuprofen but later required a stronger analgesic due to increasing pain intensity. Fentanyl's conversion to morphine in the body makes it a likely choice for managing the patient's continuous but moderate bone pain.

Correct Answer: D

Rationale: Naltrexone, an opiate receptor antagonist, was likely administered to the patient to facilitate avoidance from ethanol dependence, as research suggests that compulsive alcohol drinking is influenced by opiate receptor activity. Naltrexone helps reduce the rewarding effects of alcohol, making it easier for the patient to abstain from drinking.

Correct Answer: C

Rationale: The patient's presentation of agitation, diaphoresis, disorientation, mydriasis, unreactive pupils, and nystagmus is consistent with Phencyclidine (PCP) intoxication. PCP is known to produce hallucinations, altered mental status, and physiological effects similar to those described in the case, making it the most likely cause of the patient's signs and symptoms.

Correct Answer: C

Rationale: The symptoms described, such as headache, depression, lack of motivation, and confusion, are commonly associated with benzodiazepine withdrawal, which includes drugs like Diazepam. This drug is used to treat anxiety and withdrawal symptoms can mimic the patient's presentation. The other options do not typically cause the specific symptoms mentioned in the scenario, making Diazepam the most likely culprit.

Correct Answer: A

Rationale: The text mentions that the patient had a blood level of morphine substantially lower than the estimated minimum lethal concentration, indicating that morphine alone did not cause the death. Considering the symptoms and circumstances described, the most likely drug that could have contributed to the patient's death when combined with morphine is cocaine. Cocaine is a stimulant drug that can increase heart rate and blood pressure, leading to potential cardiovascular complications when used concurrently with opioids like morphine. Additionally, the patient being a drug user who tried different drugs increases the likelihood of cocaine use due to its common recreational use in party settings.