Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis?

Choice A reason:
Metoprolol is a beta-blocker that primarily affects the heart by reducing heart rate and contractility. It does not specifically block the efflux of potassium. Beta-blockers are used to manage high blood pressure, angina, and certain arrhythmias, but they do not target potassium channels directly.

Choice B reason:
Amiodarone is an antiarrhythmic medication that blocks the efflux of potassium from cardiac cells. It prolongs the repolarization phase of the cardiac action potential by inhibiting potassium channels, which helps to stabilize cardiac rhythms and prevent arrhythmias. This mechanism makes amiodarone effective in treating various types of arrhythmias.

Choice C reason:
Lidocaine is a class IB antiarrhythmic that primarily blocks sodium channels in the heart. It is used to treat acute ventricular arrhythmias, especially after a myocardial infarction. While it affects the electrical activity of the heart, it does not specifically block potassium efflux.

Choice D reason:
Verapamil is a calcium channel blocker that primarily affects the influx of calcium into cardiac and smooth muscle cells. It is used to treat hypertension, angina, and certain arrhythmias, but it does not block potassium efflux.

Choice A reason:
Sucralfate does not primarily work by reducing acid production but rather by forming a protective barrier over ulcers. The statement "Sucralfate reduces acid production in the stomach" is incorrect. Sucralfate's main action is to adhere to the ulcer site and protect it, thus helping in the healing process. The student’s misunderstanding is that sucralfate reduces acid production, which is not the primary mechanism of action for this medication.

Choice B reason:
Sucralfate is known for having minimal systemic side effects because it works locally in the stomach rather than being absorbed into the bloodstream. The statement that sucralfate does not cause systemic side effects is correct, as sucralfate's action is mainly localized to the gastrointestinal tract, making systemic side effects uncommon.

Choice C reason:
Sucralfate should indeed be administered one hour before meals. This timing allows it to form a protective barrier on the stomach lining before food can stimulate acid production, which is crucial for its effectiveness in treating peptic ulcers. Therefore, the statement about its administration time is correct and does not indicate a need for further teaching.