DO Pharmacology and Therapeutics 2

Question 1

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

Accepted Answer

Serotonin syndrome

Answer

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

Question 2

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

Accepted Answer

Metoprolol

Answer

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

Question 3

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

Accepted Answer

Replenishing glutathione stores to detoxify NAPQI

Answer

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

Question 4

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

Accepted Answer

Allopurinol

Answer

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

Question 5

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

Accepted Answer

Ibuprofen (NSAID)

Answer

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

DO - Doctor of Osteopathy Practice Test

DO - Doctor of Osteopathy Practice Test

DO Pharmacology and Therapeutics 2