Which of the following molecular actions in the enteric nervous system most likely mediated the adverse effect of the drug in the 54-year-old woman?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Increased serotonergic activity. The adverse effect experienced by the 54-year-old woman is likely mediated by increased serotonergic activity in the enteric nervous system. Central nervous system stimulants can lead to increased serotonin levels, which can cause adverse effects such as gastrointestinal disturbances. Option A) Blockade of M receptors is incorrect because it refers to muscarinic receptors, which are not typically associated with adverse effects in the enteric nervous system related to CNS stimulants. Option C) Activation of beta receptors is incorrect as beta receptors are more related to the sympathetic nervous system rather than the enteric nervous system. Option D) Increased adrenergic activity is also incorrect because adrenergic activity is associated with the sympathetic nervous system and not typically involved in adverse effects in the enteric nervous system. Educationally, understanding the molecular actions of drugs on the enteric nervous system is crucial for healthcare professionals to anticipate and manage potential adverse effects in patients. This knowledge helps in providing safe and effective care to individuals receiving CNS stimulants and related drugs.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Amitriptyline. Amitriptyline is a tricyclic antidepressant that is sometimes used off-label for its sedative effects, making it a likely choice for a patient experiencing heavy drowsiness. Option B) Lithium is a mood stabilizer used primarily in the treatment of bipolar disorder and is not typically associated with drowsiness as a side effect. Option C) Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety, and it is not known to cause heavy drowsiness. Option D) Haloperidol is an antipsychotic medication used to treat psychotic disorders and agitation but is not usually associated with causing heavy drowsiness. In an educational context, understanding the side effects and primary uses of different drug classes is crucial for nurses and healthcare professionals to make appropriate clinical decisions. Knowing the specific indications and side effect profiles of various medications helps in providing safe and effective care to patients.

Correct Answer: A

Rationale: The correct answer is A. Increased synthesis of adenylyl cyclase. One of the leading hypotheses about the molecular mechanism of action of lithium is its ability to increase the synthesis of adenylyl cyclase. Adenylyl cyclase is an enzyme involved in the production of cyclic adenosine monophosphate (cAMP), which plays a role in cellular signaling pathways. By increasing the synthesis of adenylyl cyclase, lithium may help to regulate intracellular signaling and neurotransmitter release, contributing to its mood-stabilizing effects in bipolar disorder.

Correct Answer: C

Rationale: Insomnia is a common early adverse effect of lithium therapy due to its impact on sleep patterns. Patients may experience difficulty falling asleep or staying asleep during the initial days of treatment. This side effect typically resolves as the body adjusts to the medication. Constipation, weight loss, hypertension, and edema are less commonly associated with lithium therapy in the early stages.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Aripiprazole. Aripiprazole is an atypical antipsychotic that is commonly used to treat conditions like Tourette syndrome, which presents with symptoms of repeated head jerking, blinking, and grimacing. Aripiprazole works by modulating dopamine and serotonin receptors in the brain, helping to reduce the frequency and severity of these involuntary movements. Option A) Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression and anxiety disorders. While it may help with some symptoms associated with Tourette syndrome, it is not the first-line treatment for the specific symptoms described in the question. Option C) Clonazepam is a benzodiazepine that is often used to treat seizures and anxiety disorders. While it may help with some symptoms of Tourette syndrome, it is not the primary medication used to address the specific symptoms of repeated head jerking, blinking, and grimacing. Option D) Naltrexone is an opioid receptor antagonist primarily used to treat alcohol and opioid dependence. It is not indicated for the treatment of movement disorders like Tourette syndrome. Educationally, understanding the mechanisms of action and indications of different drug classes is crucial for nursing practice. By knowing which medications are appropriate for specific conditions, nurses can provide safe and effective care to their patients. In this case, recognizing that aripiprazole is the preferred choice for treating Tourette syndrome symptoms can lead to improved patient outcomes and quality of life.