Which of the following patients should avoid using albuterol?

Correct Answer: A

Rationale: The correct answer is A: A patient with a history of glaucoma. Albuterol can potentially worsen glaucoma due to its side effect of increasing intraocular pressure. Patients with glaucoma should avoid using albuterol to prevent exacerbating their condition. Patients with asthma (B) benefit from albuterol as it is a bronchodilator. Cough (C) can be a symptom of conditions that albuterol may help treat. Albuterol is generally safe for pregnant patients (D) when the benefits outweigh the risks.

Correct Answer: A

Rationale: The correct answer is A: A selective serotonin reuptake inhibitor (SSRI). Fluoxetine falls under this class by specifically inhibiting the reuptake of serotonin, leading to increased serotonin levels in the brain. This mechanism helps alleviate symptoms of depression. Other choices are incorrect because fluoxetine is not an MAOI (B), TCA (C), or SNRI (D), as it does not primarily target monoamine oxidase enzymes, nor does it have the tricyclic structure or target both serotonin and norepinephrine reuptake.

Correct Answer: A

Rationale: The correct answer is A: Dry cough. Lisinopril, an ACE inhibitor, commonly causes a dry, persistent cough due to its effect on bradykinin levels. This side effect is distinct and prevalent compared to others like fatigue, weight gain, or hyperkalemia. Fatigue and weight gain are less common side effects of lisinopril, while hyperkalemia is a potential but less frequent adverse reaction associated with ACE inhibitors. Overall, the prevalence and mechanism of dry cough make it the most common side effect of lisinopril.

Correct Answer: A

Rationale: The correct answer is A because the therapeutic index (TI) is a measure of a drug's safety margin. A higher TI indicates a safer drug as it represents the ratio between the dose that produces therapeutic effects and the dose that causes toxicity. If the therapeutic dose is much lower than the toxic dose, it results in a higher TI, indicating a safer drug. Choice B is incorrect because a TI of 1 indicates that the therapeutic dose is equal to the toxic dose, which is not desirable. Choice C is incorrect as the presence of unwanted adverse effects does not necessarily impact the TI directly. Choice D is incorrect because the margin of safety for Digoxin is 0.8-2 ng/ml, so a level of 1.8 ng/ml would fall within the safe range, not pose a danger.

Correct Answer: D

Rationale: The correct answer is D: Diphenhydramine. Diphenhydramine is a first-generation antihistamine that can help prevent allergic reactions to contrast media. It works by blocking the action of histamine, which is released during allergic reactions. This drug is commonly used for pre-medication to prevent allergic reactions to contrast media in patients with a history of mild reactions. Choice A (Fluorocortisone) is a corticosteroid and is not typically used for preventing allergic reactions to contrast media. Choice B (Famotidine) is a histamine-2 blocker used for stomach acid reduction and is not indicated for preventing allergic reactions. Choice C (Zafirlukast) is a leukotriene receptor antagonist used for asthma and allergies, but it is not typically used for pre-medication before MRI with contrast media.