SPEX SPEX Pharmacology 3

Question 1

Which opioid analgesic is considered safest in patients with renal failure due to lack of active metabolite accumulation?

Accepted Answer

Fentanyl

Answer

Fentanyl lacks active renally-cleared metabolites, making it relatively safer in renal failure compared to morphine or codeine.

Question 2

What is the antidote for acetaminophen overdose?

Accepted Answer

N-acetylcysteine

Answer

N-acetylcysteine replenishes glutathione stores, neutralizing the toxic acetaminophen metabolite NAPQI and preventing hepatotoxicity.

Question 3

Which drug used for type 2 diabetes carries the highest risk of hypoglycemia when used as monotherapy?

Accepted Answer

Glipizide

Answer

Sulfonylureas like glipizide stimulate insulin secretion regardless of glucose levels, causing hypoglycemia even in monotherapy.

Question 4

A physician prescribes digoxin for heart failure. Which electrolyte abnormality potentiates digoxin toxicity?

Accepted Answer

Hypokalemia

Answer

Hypokalemia increases digoxin binding to Na+/K+-ATPase, potentiating toxicity and increasing risk of arrhythmias.

Question 5

Which class of drugs is contraindicated in pregnancy due to causing fetal renal dysgenesis and oligohydramnios?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors and ARBs are teratogenic in the second and third trimesters, causing fetal renal dysfunction, oligohydramnios, and limb deformities.

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