A patient with hypertension is prescribed a nonselective beta-blocker. The nurse reviewing this patient’s chart before administering the medication will be most concerned about which other disease process?

Choice A reason: Selectivity ensures a drug targets specific receptors, minimizing side effects. This is a key property of an ideal drug, making it a correct choice.

Choice B reason: Safety is critical, ensuring the drug causes minimal harm at therapeutic doses. This is a fundamental ideal drug property, so it is correct.

Choice C reason: Effectiveness ensures the drug achieves its intended therapeutic effect. This is essential for an ideal drug, making it a correct choice.

Choice D reason: Irreversible action is not ideal; reversible effects allow control and safety. The ‘Big Three’ focus on efficacy, safety, and selectivity, so this is incorrect.

Choice E reason: A trade name aids marketing but is not a pharmacological property. Effectiveness, safety, and selectivity are primary, so this is incorrect.

Choice A reason: Morphine, an opioid, binds to mu, kappa, and delta receptors in the brain, spinal cord, and gastrointestinal tract. Mu receptors in the gut slow peristalsis, causing constipation, while central receptors relieve pain. This multi-receptor binding explains both therapeutic and side effects, making this the correct choice.

Choice B reason: Constipation from morphine occurs at therapeutic, not just toxic, doses due to mu receptor activation in the gastrointestinal tract, which reduces motility. Toxicity may worsen side effects, but constipation is a common effect at standard doses, making this choice inaccurate for explaining morphine’s mechanism.

Choice C reason: Morphine’s receptors (e.g., mu) regulate multiple processes, but the drug itself isn’t selective to multifunctional receptors. It binds broadly to opioid receptors, causing both analgesia and side effects like constipation. This choice misrepresents morphine’s non-selective binding, making it less accurate than choice A.

Choice D reason: Morphine’s effects, including analgesia and constipation, result from specific receptor binding, not coincidental processes. It activates opioid receptors in the brain for pain relief and in the gut for reduced motility. This choice incorrectly suggests constipation is unrelated to morphine’s pharmacological action, making it incorrect.