Which of the following terms best describes the antagonism of leukotriene's bronchoconstrictor effect (mediated at leukotriene receptors) by terbutaline (acting α adrenoceptors) in a patient with asthma?

Correct Answer: C

Rationale: In this question, the correct answer is C) Physiologic antagonist. This term best describes the interaction between terbutaline and leukotrienes in the context of asthma treatment. Terbutaline, acting on α adrenoceptors, counteracts the bronchoconstrictor effect of leukotrienes at their receptors, leading to bronchodilation and improved breathing in asthma patients. Option A) Pharmacologic antagonist refers to drugs that directly bind to receptors to block the effects of endogenous compounds. Terbutaline and leukotrienes do not directly bind to each other's receptors in a competitive manner. Option B) Partial agonist indicates a drug that activates a receptor but to a lesser extent than a full agonist. Terbutaline's action as an agonist at α adrenoceptors is not partial but rather specific in counteracting leukotriene effects. Option D) Chemical antagonist involves direct chemical interaction with a drug to neutralize its effects. Terbutaline and leukotrienes do not neutralize each other through a direct chemical reaction. Educationally, understanding the concept of physiological antagonism is crucial for healthcare professionals managing asthma. It highlights how drugs with different mechanisms of action can work together to achieve a therapeutic benefit by counteracting each other's effects. This knowledge is essential for optimizing treatment strategies and improving patient outcomes in respiratory conditions like asthma.

Correct Answer: C

Rationale: The correct answer is C) Metoprolol. Metoprolol is a beta-blocker that is commonly used to manage essential tremor. In a patient with pulmonary disease, beta-blockers are preferred over other options due to their relatively lower risk of respiratory side effects compared to other classes of medications. Option A) Diazepam is a benzodiazepine that can cause respiratory depression, making it less suitable for a patient with pulmonary disease. Option B) Levodopa is a medication primarily used in Parkinson's disease and is not the first-line treatment for essential tremor. Option D) Propranolol is also a beta-blocker like Metoprolol but has a higher risk of causing bronchoconstriction in patients with pulmonary disease due to its non-selective beta-blocking properties. Educationally, understanding the pharmacological properties of medications is crucial for healthcare providers to make appropriate treatment decisions based on individual patient characteristics and comorbidities. In this case, recognizing the respiratory effects of different drug classes can help in selecting the most suitable option for a patient with specific pulmonary conditions while managing their essential tremor effectively.

Correct Answer: D

Rationale: The correct answer is D) Peak expiratory flow rate (PEFR). PEFR is a simple, non-invasive test that measures how fast a person can exhale. In asthma management, monitoring PEFR at home helps patients assess their lung function, track changes, and determine the severity of an asthma attack. If PEFR drops significantly, it indicates worsening asthma symptoms and the need for immediate medical attention. Option A) Forced expiratory volume in one second (FEV) is a valuable measure of lung function but is typically performed in a clinical setting using specialized equipment, not at home by patients. Option B) Forced vital capacity (FVC) is another measure of lung function but is not as sensitive to changes in asthma symptoms compared to PEFR. Option C) Total lung capacity (TLC) is a measure of the maximum amount of air the lungs can hold and is not typically used for monitoring asthma or determining the need for emergency care. Educationally, understanding the importance of home monitoring tools like PEFR empowers patients to take an active role in managing their asthma, leading to better outcomes and timely interventions when necessary. It also highlights the significance of personalized asthma action plans that incorporate regular monitoring of lung function parameters.

Correct Answer: A

Rationale: In this question, the correct answer is A) Atrophic rhinitis. Prolonged use of nasal decongestant drops can lead to atrophic rhinitis, which is a condition characterized by the thinning and inflammation of the nasal mucosa. This occurs due to the vasoconstrictive properties of these drops, which over time can damage the delicate nasal tissues and lead to chronic inflammation and dryness. Option B) Hypertrophy of nasal mucosa is incorrect because nasal decongestant drops actually cause thinning of the nasal mucosa, not hypertrophy or thickening. Option C) Naso-pharyngeal moniliasis is incorrect as this is a fungal infection and is not directly related to the use of nasal decongestant drops. Option D) Blockage of Eustachian tubes is incorrect as this is not a common complication of prolonged use of nasal decongestant drops. Educationally, it is important for students to understand the potential complications of using medications like nasal decongestant drops, especially when used for extended periods. This knowledge can help healthcare professionals make informed decisions when recommending or prescribing these medications to patients, emphasizing the importance of using them as directed and for the appropriate duration to avoid adverse effects like atrophic rhinitis.

Correct Answer: B

Rationale: The correct answer is B) Dangerous ventricular arrhythmias can occur. When erythromycin is given with terfenadine, it can lead to QT interval prolongation, potentially causing ventricular arrhythmias like torsades de pointes. This is due to erythromycin inhibiting the metabolism of terfenadine, leading to increased levels of terfenadine in the body. Option A is incorrect because erythromycin inhibits, not induces, the metabolism of terfenadine. Option C is incorrect because terfenadine does not inhibit the metabolism of erythromycin. Option D is incorrect because terfenadine's actions do not antagonize the antimicrobial action of erythromycin. In an educational context, understanding drug interactions is crucial for healthcare professionals to prevent adverse effects and ensure patient safety. This scenario highlights the importance of knowing how certain drugs can interact to cause potentially life-threatening complications. Healthcare providers must be aware of these interactions to make informed decisions when prescribing medications to avoid harm to patients.