What is the major reason that monoamine oxidase inhibitors (MAOIs) are rarely used in clinical practice today?
They are under a scheduled drug classification.
They are ineffective in treating depression or anxiety disorders.
They can cause gastrointestinal (GI) bleeding and esophageal varices.
They may cause dangerous interactions with some foods and drugs.
The Correct Answer is D
A. While MAOIs may have some regulatory considerations, they are not classified under a scheduled drug classification like controlled substances.
B. MAOIs are effective in treating depression and anxiety disorders, which is not the reason for their limited use.
C. Although MAOIs can have some side effects, they are more notably associated with dietary and drug interactions rather than causing GI bleeding or esophageal varices.
D. MAOIs can cause dangerous interactions with foods that contain tyramine (like aged cheeses and fermented products) and certain medications, leading to hypertensive crises, making their use cautious and limiting in clinical practice.
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Correct Answer is A
Explanation
A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.
B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.
C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.
D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.
Correct Answer is A
Explanation
A. Spironolactone is a potassium-sparing diuretic, meaning it helps retain potassium while promoting sodium and water excretion. This makes it advantageous for clients who may be at risk for hypokalemia with furosemide, which can lead to significant potassium loss.
B. This statement is incorrect; spironolactone causes less potassium loss compared to furosemide, making it a better option for those needing to maintain potassium levels.
C. This statement is misleading; spironolactone does promote diuresis but does not cause greater water losses than furosemide.
D. This is incorrect; while spironolactone does promote sodium excretion, it does not do so to a greater extent than furosemide, which is a more potent diuretic.