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A 32-year-old woman presents for follow-up after being prescribed zolpidem 10 mg nightly for short-term treatment of insomnia. She reports that although the medication helps her fall asleep, she often experiences morning grogginess, impaired concentration at work, and difficulty driving safely the next day. She denies alcohol or other sedative use. Her BMI is 23, and liver and renal function tests are normal. Which pharmacokinetic factor best explains her increased sensitivity to zolpidem? 

A 10-year-old boy with ADHD has been treated with amphetamine-dextroamphetamine XR 20 mg daily for the past month. His parents report that while his attention has improved, he has become increasingly irritable, anxious, and emotionally labile, especially in the afternoons. His appetite and sleep are otherwise stable. Physical exam is unremarkable, vitals are normal, and growth parameters are appropriate. What is the most appropriate next step in management? 

Which antipsychotic is least likely to worsen Parkinson’s symptoms? 

Which opioid adverse effect does not develop tolerance? 

Physical dependence occurs when: 

A patient with chronic tension-type headaches asks about first-line treatment. Best recommendation? 

A neonate requires gentamicin dosing. The NP considers: 

Which is a hallmark of CNS drug therapy? 

Which route bypasses first-pass hepatic metabolism? 

A 52-year-old woman with a 25–pack-year history of smoking presents to discuss pharmacologic options for cessation. She reports prior unsuccessful attempts with nicotine replacement therapy. Her past medical history includes type 2 diabetes mellitus and obesity, but no history of seizures, head trauma, or eating disorders. She is not currently depressed but reports mild anhedonia when she has tried to quit in the past. The NP considers starting bupropion SR. Through which primary mechanism does this medication reduce nicotine cravings and withdrawal symptoms?