Which of the following cells increase acid in the stomach? (Select all that apply)

Choice A reason: Patient preference is not a primary concern in food-drug interactions; physiological effects are. Grapefruit’s impact on metabolism is significant, so this is incorrect for the true statement.

Choice B reason: Foods can alter absorption and metabolism, but some also affect drug action (e.g., tyramine with MAOIs). This statement is incomplete, making it incorrect compared to grapefruit’s specific effect.

Choice C reason: Grapefruit inhibits CYP isoenzymes, altering drug metabolism and increasing drug levels. This is a well-documented interaction, making it the correct true statement about food-drug interactions.

Choice D reason: Not all medications are best absorbed with food; some require empty stomachs. Grapefruit’s metabolic interaction is more accurate, so this is incorrect for the true statement.

Choice A reason: Theophylline is rarely used due to toxicity risks and less efficacy compared to beta-agonists. Increasing fluticasone dose doesn’t address acute exacerbations, as inhaled corticosteroids act slowly. Oxygen is appropriate, but this regimen lacks rapid-acting bronchodilators, making it inadequate for acute asthma management.

Choice B reason: Four puffs of albuterol via inhaler may be insufficient for severe asthma (90% saturation, wheezes). Theophylline is outdated, and nebulized treatments are more effective in emergencies. Oxygen is needed, but this combination lacks systemic steroids for inflammation, making it less optimal.

Choice C reason: Intravenous glucocorticoids reduce airway inflammation rapidly, nebulized albuterol and ipratropium provide synergistic bronchodilation, and oxygen corrects hypoxia (90% saturation). This aligns with guidelines for acute asthma exacerbations, addressing inflammation, bronchoconstriction, and oxygenation, making it the correct and comprehensive treatment choice.

Choice D reason: Intramuscular glucocorticoids are slower than intravenous for acute asthma. Salmeterol, a long-acting beta-agonist, is inappropriate for acute exacerbations, as it lacks rapid onset. Oxygen is needed, but this regimen doesn’t address immediate bronchoconstriction effectively, making it incorrect for emergency management.