Which pain theory is based on the existence of a specific pain system?

Correct Answer: D

Rationale: The specificity theory of pain proposes that there is a specific pain system in the body that is responsible for detecting and transmitting pain signals. According to this theory, specific pain receptors exist that are sensitive only to pain stimuli and are separate from other sensory receptors for touch, temperature, or pressure. When tissue damage or injury occurs, these pain receptors are activated, and they send signals through specific pain pathways to the brain, resulting in the sensation of pain. The specificity theory suggests that pain is a distinct sensory modality with its own dedicated system, separate from other sensory modalities.

Correct Answer: C

Rationale: The response, "This drug is the first medication your health care provider will use to treat your angina," is accurate because Ranexa (ranolazine) is commonly used as a first-line treatment for chronic angina. It is typically prescribed when other angina medications, such as beta-blockers or calcium channel blockers, are not sufficient or well-tolerated by the patient. Ranexa works by helping the heart muscle to relax, which can improve blood flow to the heart and reduce angina symptoms. It is important for the patient to understand that Ranexa is specifically intended to treat angina and should not be used for other conditions without consulting their healthcare provider.

Correct Answer: C

Rationale: Glyceryl trinitrate (nitroglycerin) is most effective when given sublingually for the treatment of angina pectoris. When administered sublingually, the medication is absorbed directly into the bloodstream through the oral mucosa, leading to rapid onset of action and providing quick relief of angina symptoms. This route bypasses first-pass metabolism in the liver, allowing the drug to exert its effects more rapidly. Orally administered glyceryl trinitrate is subject to extensive first-pass metabolism, and intravenous or intramuscular routes are generally reserved for acute situations where rapid onset of action is required. Subcutaneous administration is less commonly used compared to the sublingual route for the treatment of angina.

Correct Answer: C

Rationale: The most common side effect that occurs with the initial therapy of Nitroglycerine due to increased vasodilation is a headache. Nitroglycerine works by dilating blood vessels to improve blood flow to the heart. This sudden increase in vasodilation can lead to headache in many individuals, especially when starting the medication. The headache is often described as a pulsating sensation and usually subsides as the body adjusts to the medication. It is important to reassure patients that this side effect is temporary and tends to improve with continued use.

Correct Answer: D

Rationale: Atropine is a parasympatholytic drug that blocks the action of the vagus nerve on the heart, typically increasing heart rate. However, in rare cases, atropine can cause an initial paradoxical slowing of the heart rate before the expected increase. This occurs because atropine may initially stimulate the vagus nerve at low doses before blocking its effects. The dose of 0.3 mg IV is relatively low, which could explain this phenomenon. The other options are incorrect because atropine does not stimulate the vagus nerve (A), the dose is not necessarily too low (B), and adenosine is not indicated for bradycardia (C).