Chapter·PharmacologyDrug interactions and adverse effects

Pharmacokinetic interaction mechanismsDownloads

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1

A 61-year-old male is given acetazolamide to treat open-angle glaucoma. Upon diuresis, his urine is found to be highly alkaline. Which of the following accounts for the alkaline nature of this patient’s urine?

AInhibition of bicarbonate reabsorption in the proximal tubule

BInhibition of bicarbonate reabsorption in beta-intercalated cells

CInhibition of acid secretion in alpha-intercalated cells

DInhibition of chloride reabsorption in the distal convoluted tubule

EInhibition of chloride reabsorption in the thick ascending loop of Henle

2

A 72-year-old man presents to the emergency department with a 1 hour history of bruising and bleeding. He says that he fell and scraped his knee on the ground. Since then, he has been unable to stop the bleeding and has developed extensive bruising around the area. He has a history of gastroesophageal reflux disease, hypertension, and atrial fibrillation for which he is taking an oral medication. He says that he recently started taking omeprazole for reflux. Which of the following processes is most likely inhibited in this patient?

ASulfation

BOxidation

CFiltration

DAcetylation

EGlucuronidation

3

A 72-year-old woman presents to the clinic complaining of diarrhea for the past week. She mentions intense fatigue and intermittent, cramping abdominal pain. She has not noticed any blood in her stool. She recalls an episode of pneumonia last month for which she was hospitalized and treated with antibiotics. She has traveled recently to Florida to visit her family and friends. Her past medical history is significant for hypertension, peptic ulcer disease, and hypercholesterolemia for which she takes losartan, esomeprazole, and atorvastatin. She also has osteoporosis, for which she takes calcium and vitamin D and occasional constipation for which she takes an over the counter laxative as needed. Physical examination shows lower abdominal tenderness but is otherwise insignificant. Blood pressure is 110/70 mm Hg, pulse is 80/min, and respiratory rate is 18/min. Stool testing is performed and reveals the presence of anaerobic, gram-positive bacilli. Which of the following increased this patient’s risk of developing this clinical presentation?

AHypercholesterolemia treated with atorvastatin

BConstipation treated with laxatives

COsteoporosis treated with calcium and vitamin D

DPeptic ulcer disease treated with esomeprazole

ERecent antibiotic use for pneumonia treatment

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