A 72-year-old woman with hypertension and osteoarthritis is prescribed digoxin. Her renal function shows eGFR 28 mL/min. What adjustment is most critical? 

A 32-year-old man with no prior cardiac history is brought to the ED after using cocaine at a party. He reports severe substernal chest pain, palpitations, and anxiety. Vitals: BP 182/102 mmHg, HR 128, RR 22. Exam shows diaphoresis and pupillary dilation. EKG demonstrates sinus tachycardia. Troponin is mildly elevated. Which pharmacologic management is most appropriate at this time? 

Which lab monitoring is essential for patients on lithium? 

A patient overdoses on amitriptyline. Which complication is most life-threatening? 

Which drug type requires especially close therapeutic monitoring? 

A 58-year-old man with a long history of alcohol use disorder is brought to the ED by his family for confusion, unsteady gait, and abnormal eye movements. On exam, he is disoriented to time, demonstrates a wide-based ataxic gait, and has bilateral lateral rectus palsy. Vitals are stable. Labs show mild macrocytic anemia and elevated AST > ALT. The NP suspects Wernicke’s encephalopathy. Which is the most appropriate immediate intervention? 

Sodium depletion has which effect on lithium therapy? 

A patient starting an SSRI asks why improvement may take weeks. The NP explains: 

A 26-year-old woman with moderate persistent asthma uses her albuterol inhaler multiple times during an exacerbation. Shortly after, she develops tremors and palpitations. Which mechanism best explains these side effects? 

Which element is legally required on a prescription?