Pharmacology and Therapeutics Flashcards

A patient prescribed an SSRI for depression develops agitation, hyperthermia, and clonus after adding tramadol. What syndrome is occurring?

Answer: Serotonin syndrome

Tramadol inhibits serotonin reuptake, and when combined with an SSRI, excessive serotonergic activity causes serotonin syndrome.

Which beta-blocker is cardioselective (β1-selective) and preferred in patients with mild asthma requiring heart rate control?

Answer: Metoprolol

Metoprolol is β1-selective and less likely to cause bronchospasm than nonselective agents like propranolol, though caution is still advised in asthma.

The antidote for acetaminophen overdose, N-acetylcysteine (NAC), works by which mechanism?

Answer: Replenishing glutathione stores to detoxify NAPQI

NAC provides cysteine for glutathione synthesis, replenishing hepatic stores depleted by NAPQI (the toxic acetaminophen metabolite) to prevent liver necrosis.

Which drug used for gout acts by inhibiting xanthine oxidase to reduce uric acid production?

Answer: Allopurinol

Allopurinol inhibits xanthine oxidase, blocking conversion of hypoxanthine and xanthine to uric acid, thereby lowering serum urate levels.

A patient on lithium develops nausea, tremor, and confusion. Which medication should be reviewed as a potential cause of lithium toxicity?

Answer: Ibuprofen (NSAID)

NSAIDs reduce renal prostaglandin synthesis, decreasing GFR and lithium clearance, which can rapidly elevate lithium levels to toxic concentrations.

Which anticoagulant requires no routine INR monitoring and acts by directly inhibiting thrombin (Factor IIa)?

Answer: Dabigatran

Dabigatran (Pradaxa) is a direct thrombin inhibitor that does not require INR monitoring unlike warfarin, and has a predictable pharmacokinetic profile.