Which of the following tricyclic and heterocyclic agents has the least sedation?

Correct Answer: A

Rationale: The correct answer is A: Protriptyline. This tricyclic agent has the least sedative effect due to its higher potency and faster metabolism compared to other options. Protriptyline has minimal sedative properties, making it a preferred choice for patients who cannot tolerate sedation. Trazodone (B), Amitriptyline (C), and Mirtazapine (D) are known to cause sedation due to their antihistaminic and alpha-adrenergic blocking effects.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Hashish is a cannabis product made from the resin of the cannabis plant. 2. Cannabis plant contains psychoactive compounds such as THC, which is also present in hashish. 3. Heroin, ecstasy, and crack are not related to cannabis and have different chemical compositions and effects. 4. Therefore, the correct answer is C (Hashish) as it is directly related to cannabis. Summary: - Choice A (Heroin) is incorrect as it is an opioid, not related to cannabis. - Choice B (Ecstasy) is incorrect as it is a synthetic drug, not related to cannabis. - Choice D (Crack) is incorrect as it is a form of cocaine, not related to cannabis. - Only choice C (Hashish) is related to cannabis due to its origin from the cannabis plant and containing similar psychoactive compounds.

Correct Answer: B

Rationale: The correct answer is B: Ipratropium. Ipratropium is a muscarinic receptor antagonist that acts as a bronchodilator, making it effective for treating asthma by relaxing the smooth muscles in the airways. Atropine (A) is a non-selective muscarinic antagonist used for bradycardia and other conditions. Platiphylline (C) is a xanthine derivative used for bronchospasm in COPD, not asthma. Metacin (D) is a cholinergic agonist used for treating glaucoma. Therefore, the most suitable choice for an anti-asthmatic agent among the options provided is Ipratropium.

Correct Answer: B

Rationale: Step-by-step rationale: 1. Pernicious anemia is caused by a deficiency in vitamin B12. 2. Cyanocobalamin is the synthetic form of vitamin B12 used to treat pernicious anemia. 3. Ferrous lactate, iron dextran, and ferrous gluconate are iron supplements, not vitamin B12. 4. Therefore, the correct answer is B (Cyanocobalamin) as it addresses the underlying cause of pernicious anemia.

Correct Answer: D

Rationale: The correct answer is D because all three drug classes are commonly used in chronic heart failure management. Cardiac glycosides like digoxin improve heart function. Diuretics help manage fluid overload. ACE inhibitors like enalapril improve outcomes by reducing the workload on the heart. Each drug class targets different aspects of heart failure progression, making a combination of these medications beneficial in managing the condition effectively. Therefore, all the above choices are correct in the context of treating chronic heart failure.