Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?

A 41-yr-old man with kidney stones

A 62-yr-old woman with acute renal failure

A 35-yr-old woman with cervical cancer

A 50-yr-old man with cirrhosis of the liver

Answer and Explanation

The Correct Answer is D

A) A 41-year-old man with kidney stones:
Kidney stones primarily affect the urinary system, and while the kidneys play a role in drug excretion, kidney stones themselves do not directly interfere with drug metabolism. Drug metabolism occurs mainly in the liver, so alterations due to kidney stones would be less likely. The liver is where most drug metabolism takes place, so drug metabolism in this case would likely be unaffected by kidney stones.

B) A 62-year-old woman with acute renal failure:
Acute renal failure impacts the kidneys' ability to filter and excrete drugs, but it doesn't directly affect the liver's ability to metabolize drugs. Renal failure can lead to drug accumulation due to decreased clearance, but metabolism (primarily liver function) is not usually altered unless the patient also has hepatic dysfunction.

C) A 35-year-old woman with cervical cancer:
Cervical cancer itself does not directly affect drug metabolism. While cancer treatments like chemotherapy or radiation therapy can affect liver and kidney function (which could impact drug metabolism), cervical cancer itself does not typically alter the metabolic pathways that drugs undergo in the body.

D) A 50-year-old man with cirrhosis of the liver:
Cirrhosis of the liver significantly impacts the liver's ability to metabolize drugs. The liver is the primary organ responsible for drug metabolism, and cirrhosis can lead to a decreased ability to break down medications, potentially resulting in drug toxicity or suboptimal therapeutic effects.

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Correct Answer is C

Explanation

A) Tacrine (Cognex): Tacrine is an acetylcholinesterase inhibitor used in the treatment of Alzheimer's disease to improve cognitive function. It is not typically used for Parkinson's disease, which is characterized by motor symptoms such as tremors, shuffling gait, and rigidity.

B) Rivastigmine (Exelon): Rivastigmine is another acetylcholinesterase inhibitor, similar to Tacrine, primarily used to treat Alzheimer's disease or dementia-related symptoms. While it helps with cognitive symptoms, it is not effective in treating the motor symptoms of Parkinson's disease.

C) Carbidopa-levodopa (Sinemet): This is the correct answer. Carbidopa-levodopa (Sinemet) is the gold standard treatment for Parkinson's disease. Levodopa is a precursor to dopamine, which helps address the dopamine deficiency in the brain that causes symptoms like tremors, shuffling gait, and lack of facial expression (masked facies). Carbidopa is added to prevent levodopa from being broken down before it reaches the brain, enhancing its effectiveness.

D) Donepezil (Aricept): Donepezil is also an acetylcholinesterase inhibitor used primarily in Alzheimer's disease. Like Tacrine and Rivastigmine, it works to improve cognitive function but does not treat the motor symptoms seen in Parkinson's disease. It would not be appropriate for managing the patient's Parkinsonian symptoms.

A. Norepinephrine B. Decarboxylase C. Catecholamine D. Acetylcholinesterase

Correct Answer is D

Explanation

A) Norepinephrine: Norepinephrine is a neurotransmitter primarily involved in the sympathetic nervous system. It is not involved in terminating the stimulation caused by acetylcholine. Norepinephrine acts on adrenergic receptors, whereas acetylcholine primarily acts on cholinergic receptors.
B) Decarboxylase: Decarboxylase is an enzyme that plays a role in the synthesis of certain neurotransmitters, including dopamine, but it does not have a role in terminating the action of acetylcholine at the effector cell. It is unrelated to the termination of acetylcholine signaling.
C) Catecholamine: Catecholamines (such as dopamine, norepinephrine, and epinephrine) are a group of neurotransmitters involved in the sympathetic nervous system. While they play a role in synaptic transmission, they are not responsible for breaking down acetylcholine or terminating its effects. Their primary function is in adrenergic signaling.
D) Acetylcholinesterase: Acetylcholinesterase is the correct enzyme. It is responsible for breaking down acetylcholine (ACh) in the synaptic cleft after it has stimulated the effector cell. By hydrolyzing acetylcholine into acetate and choline, acetylcholinesterase effectively terminates the signal and allows the effector cell's membrane to repolarize. This action prevents continuous stimulation and ensures proper function of the cholinergic system.

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Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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