G notes

Question 1

Patient Care and Safety: Herbal Remedies in Pregnancy

Answer 1

Concepts: Herbal remedies, Pregnancy safety
Clinical Situation: A 25-year-old woman wants to use herbal remedies during pregnancy.
Important Points:
Herbal remedies lack proven safety ratings for pregnant women.
Emphasize the importance of consulting healthcare providers before using herbal products during pregnancy due to potential risks.
Drugs and Rationale:
Herbal remedies are not regulated like pharmaceuticals, leading to variability in potency and purity.

Question 2

Pharmacology: Acetaminophen Overdose

Answer 2

Concepts: Drug toxicity, Hepatotoxicity
Clinical Situation: A 38-year-old man overdoses on acetaminophen.
Important Points:
Hepatic necrosis is the most serious toxic effect of acetaminophen overdose.
Acute overdose can cause severe liver damage, leading to liver failure if not promptly treated.
Drugs and Rationale:
N-Acetylcysteine (NAC) is the antidote for acetaminophen overdose and works by replenishing glutathione.

Question 3

Endocrine Disorders: Selective Estrogen Receptor Modulators (SERMs)

Answer 3

Concepts: Osteoporosis treatment, Contraindications
Clinical Situation: A 51-year-old woman on SERMs for postmenopausal osteoporosis.
Important Points:
Venous thromboembolism is a contraindication for SERMs.
SERMs can increase the risk of blood clots, which is critical in patients with a history of thromboembolic events.
Drugs and Rationale:
Raloxifene (Evista): used for osteoporosis, but careful monitoring is needed for thromboembolic risks.

Question 4

Pediatrics: Aspirin Use in Children

Answer 4

Concepts: Reye’s syndrome, Safe antipyretics
Clinical Situation: A 6-year-old with chickenpox and fever.
Important Points:
Aspirin is contraindicated in children with viral infections due to the risk of Reye’s syndrome.
Acetaminophen or ibuprofen are safer alternatives for reducing fever in children.
Drugs and Rationale:
Acetaminophen (Tylenol): preferred for fever management in pediatric patients.

Question 5

Gastrointestinal Disorders: Sodium Bicarbonate Overuse

Answer 5

Concepts: Acid-base imbalances, Antacid use
Clinical Situation: A 75-year-old woman with muscle twitching after excessive sodium bicarbonate intake.
Important Points:
Metabolic alkalosis can occur with overuse of sodium bicarbonate.
Symptoms include muscle twitching, nausea, and headache due to alkalotic state.
Drugs and Rationale:
Sodium Bicarbonate: overuse can lead to alkalosis, requiring careful monitoring of acid-base balance.

Question 6

Infectious Disease: Quinolone Adverse Effects

Answer 6

Concepts: Antibiotic therapy, Drug safety in older adults
Clinical Situation: A 79-year-old patient on a quinolone for infection.
Important Points:
Tendonitis and tendon rupture are associated adverse effects with quinolones, particularly in older adults.
Close monitoring is necessary to prevent tendon damage.
Drugs and Rationale:
Ciprofloxacin (Cipro): a commonly used quinolone with potential for severe musculoskeletal side effects.

Question 7

Cardiovascular and Renal Systems: Diuretic Use and Orthostatic Hypotension

Answer 7

Concepts: Hypertension management, Fall prevention
Clinical Situation: A 79-year-old on a diuretic for hypertension.
Important Points:
Orthostatic hypotension is a risk with diuretics, necessitating precautions when standing.
Educate on the importance of rising slowly to prevent falls.
Drugs and Rationale:
Hydrochlorothiazide (HCTZ): commonly prescribed diuretic requiring patient education on side effects.

Question 8

Toxicology: Salicylate Intoxication in Children

Answer 8

Concepts: Poisoning, Emergency assessment
Clinical Situation: A toddler potentially ingests an entire bottle of aspirin.
Important Points:
Hyperventilation and drowsiness are common signs of salicylate intoxication in children.
Immediate medical evaluation is crucial.
Drugs and Rationale:
Activated Charcoal: used in acute overdose to reduce absorption if presented early.

Question 9

Oncology: Monoclonal Antibodies

Answer 9

Concepts: Targeted cancer therapy
Clinical Situation: A patient asks about monoclonal antibodies for cancer treatment.
Important Points:
Monoclonal antibodies target specific tumor cells while sparing normal cells, reducing side effects.
Drugs and Rationale:
Rituximab (Rituxan): a monoclonal antibody used in various cancers, demonstrating targeted therapy advantages.

Question 10

Gastrointestinal Disorders: Antidiarrheal Medications

Answer 10

Concepts: Drug actions, Side effects
Clinical Situation: A patient asks about the difference between Lomotil and Imodium.
Important Points:
Imodium (loperamide) does not cause physical dependence, unlike Lomotil (diphenoxylate/atropine).
Drugs and Rationale:
Loperamide (Imodium): preferred for its safety profile in long-term use.

Question 11

Geriatric Considerations: Herbal Supplements and Drug Interactions

Answer 11

Concepts: Herbal supplements, Drug interactions
Clinical Situation: A patient wants to take ginkgo for memory.
Important Points:
Ginkgo biloba can increase bleeding risk, especially when taken with anticoagulants like aspirin.
Drugs and Rationale:
Ginkgo Biloba: herbal supplement requiring caution with concurrent anticoagulant or antiplatelet therapy.