MDcooper wrote:
31.A 72-year-old African American man with a history of renal dysfunction, congestive heart failure, and previous myocardial infarction is currently undergoing dialysis. Until the past few weeks, he has been in good spirits and has a strong family support system that helps him in getting to and from dialysis daily. Over the past few weeks, however, he has been feeling increasingly depressed and has begun to act bizarrely, with persecutory delusions that the government is poisoning the chemicals used on him for dialysis. Also in the last few weeks, due to increased stomach pain, his medications have been adjusted and now include cimetidine for stomach ulcers, digoxin, and a baby aspirin daily. He also takes docusate sodium as needed for stool softening and ibuprofen as needed for mild arthritis pain. Which of the following medications would be most likely to have induced the symptoms the patient is now experiencing?
A. Aspirin
B. Cimetidine
C. Digoxin
D. Docusate sodium
E. Ibuprofen
Hi,
The main cause of drug side effects is high drug concentration at the receptor site.
Both cimetidine & digoxin can cause depression & delirium ( I couldn't found exactly " delusion" in the books ).
Cimetidine is removed by dialysis, but dig. does not & also it's half life is much longer, specially in renal failure; so I think it's dig. ( C ).
But if only cimetidine is recently added ( due to history of HF ); B might be the answer.
pringo6@hotmail.com
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| MDcooper
Forum Guru
Topics: 211
Posts: 470
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yes cemitidine
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