Beta Blockers USMLE Step 1 Practice Question
A 61 year old woman with cirrhosis due to hepatitis C develops severe nausea after chemotherapy. She is given a usual oral dose of a medication that is extensively metabolized in the liver before reaching the systemic circulation. Soon afterward she develops excessive sedation compared with prior treatment. Blood pressure is 108/66 mm Hg and pulse is 74 per minute. Which of the following best explains the increased drug effect in this patient?
Answer choices
- ADecreased volume of distribution
- BIncreased plasma protein binding
- CDecreased first pass metabolismCorrect answer
- DInduction of cytochrome P450 enzymes
- EIncreased renal secretion
- FIncreased absorption rate from the gastrointestinal tract
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