Therapeutic Applications and Clinical Use Flashcards

A patient taking lithium for bipolar disorder develops polyuria and polydipsia. These symptoms suggest:

Answer: Nephrogenic diabetes insipidus

Chronic lithium use impairs renal tubular response to ADH, causing nephrogenic diabetes insipidus.

Which antihypertensive drug class is absolutely contraindicated in bilateral renal artery stenosis?

Answer: ACE inhibitors

ACE inhibitors dilate the efferent arteriole, critically reducing GFR in patients dependent on angiotensin II for glomerular filtration.

Which drug used for Parkinson's disease works by inhibiting MAO-B and thereby preserving dopamine in the striatum?

Answer: Selegiline

Selegiline selectively inhibits MAO-B, slowing dopamine breakdown and extending its effect in the basal ganglia.

A post-myocardial infarction patient is prescribed a beta-blocker. The primary goal in this setting is to:

Answer: Reduce cardiac remodeling and mortality

Beta-blockers reduce sympathetic activation post-MI, decreasing ventricular remodeling and all-cause mortality.

Vancomycin is the drug of choice for MRSA infections. Its mechanism is:

Answer: Binding to D-Ala-D-Ala peptidoglycan precursors blocking cell wall synthesis

Vancomycin binds to D-Ala-D-Ala termini of peptidoglycan precursors, preventing cross-linking and weakening the bacterial cell wall.

Furosemide is a loop diuretic used in acute pulmonary edema. Its rapid clinical effect is achieved by:

Answer: Inhibiting Na+/K+/2Cl- cotransporter in the loop of Henle

Furosemide inhibits the NKCC2 transporter in the thick ascending loop of Henle, producing a rapid, profound diuresis.

A patient on heparin therapy develops HIT (heparin-induced thrombocytopenia). The appropriate management is to:

Answer: Discontinue heparin and start argatroban

HIT requires immediate cessation of all heparin products and initiation of a direct thrombin inhibitor like argatroban.