Order: 1000 mL of D5½NS with 1 ampule of multiple vitamins to infuse over 8 hours

Available: Macrodrip set: 15 gtt/mL

Calculate the IV flow rate in gtt/min.

A) Neutropenia
Neutropenia refers to an abnormally low level of neutrophils, a type of white blood cell. While certain medications, such as chemotherapy agents and some antipsychotic drugs, can cause neutropenia, atenolol (a beta-blocker) is not typically associated with this side effect. Atenolol primarily affects the cardiovascular system by reducing heart rate and blood pressure, and it is not known to cause significant changes in white blood cell counts.

B) Bradycardia
Bradycardia, or a slower-than-normal heart rate, is a well-known and common adverse effect of beta-blockers, including atenolol. Beta-blockers work by blocking beta-adrenergic receptors, which decreases the heart rate and the force of contraction, as well as lowering blood pressure. In some individuals, this can lead to excessively low heart rates, which could be dangerous if the heart rate drops too much. Bradycardia can lead to symptoms such as dizziness, fainting, or fatigue, and may require dose adjustments or discontinuation of the medication

C) Anemia
Anemia, which is a condition characterized by a low red blood cell count or low hemoglobin levels, is generally not a common adverse effect of atenolol. While certain medications like some chemotherapeutic agents, NSAIDs, or antibiotics may cause anemia due to their effects on the bone marrow or by causing gastrointestinal bleeding, atenolol is not typically linked to this side effect.

D) Hypokalemia
Hypokalemia (low potassium levels) is typically associated with the use of diuretics or other medications that cause the kidneys to excrete more potassium, such as some classes of antibiotics and corticosteroids. However, atenolol, being a beta-blocker, does not directly affect potassium levels.

A) Gastric emptying time:
Gastric emptying time plays a significant role in drug absorption. The faster the stomach empties its contents into the small intestine, the quicker the drug can be absorbed. If gastric emptying is delayed, such as with certain diseases, medications, or conditions (like gastroparesis), drug absorption may be slowed. Conversely, rapid gastric emptying can lead to quicker absorption, potentially reducing the time the drug has to exert its effects.

B) Capillary walls with large spaces between cells:
Capillary permeability influences how easily a drug can pass from the bloodstream into tissues. If the capillary walls have large gaps, such as in certain areas of the body (e.g., in the liver or spleen), drugs can more easily move across the capillary membrane and be absorbed into the system.

C) Stability and solubility of the medication:
For a drug to be absorbed effectively, it must be stable in the body and soluble in bodily fluids. Drugs that are poorly soluble or unstable in the stomach may not be absorbed efficiently. For instance, medications that are lipophilic (fat-soluble) may require a carrier or special formulation (e.g., emulsions or nanoparticles) to aid in absorption, whereas hydrophilic drugs may face challenges crossing cell membranes without assistance.

D) Inspiratory effort:
Inspiratory effort does not directly affect the absorption of drugs. Inspiratory effort refers to the act of inhaling, which is more relevant to drugs administered via inhalation (e.g., inhalers or nebulizers). It affects how well the drug is delivered to the lungs but does not influence absorption in the gastrointestinal tract or other routes of administration.

E) Presence of food in the stomach or intestines:
Food in the stomach or intestines can either speed up or slow down drug absorption. Some drugs are absorbed better on an empty stomach because food can slow gastric emptying and alter the drug's solubility. On the other hand, certain medications (e.g., fat-soluble drugs) may require food for optimal absorption.