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 C
Explanation
A. Hypertension can affect drug distribution to some extent due to altered perfusion but is not the most significant factor impacting distribution, especially for a local condition like cellulitis.
B. Liver dysfunction primarily affects the metabolism and clearance of drugs rather than their distribution, although it may indirectly influence distribution by altering protein binding.
C. Peripheral vascular disease significantly impacts blood flow to the extremities, which can hinder the distribution of the antibiotic to the affected area (the left leg) where the cellulitis is present, leading to reduced drug efficacy.
D. Diverticulitis disease primarily affects the gastrointestinal system and would not directly influence the distribution of an antibiotic used to treat cellulitis in the leg.
Correct Answer is D
Explanation
A. By directly relaxing vascular smooth muscle is not how lisinopril primarily works; it does not act directly on smooth muscle but rather affects hormonal pathways.
B. By blocking aldosterone from binding to mineralocorticoid receptors is a secondary effect of the angiotensin-converting enzyme (ACE) inhibitors but not the primary action of lisinopril itself.
C. By blocking the movement of calcium ions into arterial smooth muscles describes the action of calcium channel blockers, not ACE inhibitors like lisinopril.
D. By inhibiting the transformation of angiotensin I to angiotensin II is the correct answer because lisinopril inhibits the ACE enzyme, reducing the production of angiotensin II, which lowers blood pressure and decreases strain on the heart.