A 54-year-old male visits your primary care office for the management of hypertension, hyperlipidemia, and ischemic heart disease. His medical history includes glaucoma, acute renal failure, and bronchospasm. You consider adding atenolol to his treatment regimen. Which of the following statements is true about atenolol?
A 52-year-old woman comes to the emergency room complaining of tremor, sweating, anxiety, and palpitations. She reports feeling weak and has difficulty speaking and walking. A fingerstick blood glucose test reveals a glucose level of 42 mg/dL (2.3 mmol/L). Her medical history includes diabetes, hypertension, a recent urinary tract infection, and a protozoal infection. Her current medications are metoprolol, levofloxacin, lisinopril, insulin, and pentamidine. Upon further evaluation, it is determined that her hypoglycemia is drug-induced. Which of the following medications can cause hypoglycemia?
A 34-year-old man is brought to the emergency room with altered mental status after taking an unknown dose of a beta blocker to manage anxiety before a public lecture. His vital signs are as follows: temperature 99°F, heart rate 59 beats per minute, respiratory rate 14 breaths per minute, and blood pressure 80/55 mm Hg. On examination, he is disoriented but recognizes his wife, with cold extremities, bradycardia, and decreased breath sounds. ECG shows bradycardia with PR prolongation and first-degree heart block. Which of the following beta blockers is the most toxic in overdose?
A 34-year-old man is brought to the emergency room with altered mental status after taking an unknown dose of propranolol to manage anxiety before a public lecture. His vital signs are as follows: temperature 99°F, heart rate 59 beats per minute, respiratory rate 14 breaths per minute, and blood pressure 80/55 mm Hg. On examination, he is disoriented but recognizes his wife, with cold extremities, bradycardia, and decreased breath sounds. ECG shows bradycardia with PR prolongation and first-degree heart block. Which of the following is true about propranolol toxicity?
A 52-year-old man presents to the emergency room with nausea, vomiting, muscle cramps, and weakness that began three days ago. He recently started Penicillin G for pharyngitis and is also taking lisinopril, atorvastatin, and spironolactone. On examination, he appears anxious, has difficulty walking, and exhibits decreased sensations and reflexes. Laboratory studies reveal a potassium level of 6.8 mmol/L, and his ECG shows changes consistent with hyperkalemia. Which of the following is the antidote of choice for life-threatening arrhythmias caused by hyperkalemia?
A 56-year-old man presents to the emergency room with nausea, vomiting, muscle cramps, and weakness that began three days ago. He started Penicillin G for acute pharyngitis five days ago and has been taking it regularly along with lisinopril, atorvastatin, and spironolactone. On examination, he appears anxious, has difficulty walking, and shows decreased sensations and reflexes in all four extremities. Laboratory studies reveal a potassium level of 6.8 mmol/L, and his ECG shows changes consistent with hyperkalemia. If his hyperkalemia progresses without treatment, what is the most likely cause of death?
A 56-year-old man presents to the emergency room with nausea, vomiting, muscle cramps, and weakness that began three days ago. Five days ago, he started taking Penicillin G for acute pharyngitis and has been using it regularly along with his other medications: lisinopril, atorvastatin, and spironolactone. On physical examination, he appears anxious and distressed, has difficulty walking, and shows decreased sensations and reflexes in all four extremities. Laboratory studies reveal a potassium level of 6.8 mmol/L. An ECG reveals changes consistent with hyperkalemia. Which of the following medications can contribute to this condition?
A 34-year-old male develops signs of lidocaine toxicity (tinnitus, dizziness, slurred speech, hypotension, and seizures) shortly after receiving multiple doses of lidocaine for a minor surgical procedure. Which of the following increases the risk of lidocaine toxicity?
A 48-year-old male with a history of liver cirrhosis is undergoing a minor surgical procedure for excision of a skin lesion. The patient was injected with 30 mL of 2% lidocaine (600 mg) without epinephrine for local anesthesia. Shortly after the injection, he reports a metallic taste in his mouth, dizziness, and ringing in his ears. Within minutes, he develops perioral numbness and confusion, followed by generalized muscle twitching. The patient becomes drowsy but responsive, with involuntary muscle twitching. Blood pressure was 140/90 mmHg, heart rate 98 bpm, and oxygen saturation was 96% on room air. His weight was 60 kg. Within moments, he becomes unresponsive and experiences a tonic-clonic seizure lasting approximately 30 seconds. After the cessation of seizure, his blood pressure drops to 80/50 mmHg, and his heart rate falls to 40 bpm, with signs of cardiovascular collapse. What is the most effective antidote to treat cardiovascular collapse in this patient?
