Nokea
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
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The pharmacology students are learning about antibiotics that are known to cause photosensitivity in some patients. What nursing measures would ensure the comfort of patients taking these antibiotics and hopefully avoid serious adverse effects?
- A. Avoiding the use of aspirin and other over-the-counter pain products
- B. Getting a wig or other head cover to avoid heat loss
- C. Avoiding exposure to sunlight or use of a sunscreen and protective clothing if exposure is inevitable
- D. Providing frequent rest periods in a dark room
Correct Answer: C
Rationale: Photosensitivity from antibiotics increases sunburn risk; avoiding sunlight or using protection prevents serious skin reactions.
The types of antagonism are:
- A. Summarized
- B. Potentiated
- C. Additive
- D. Competitive
Correct Answer: D
Rationale: Competitive antagonism is a recognized type, involving receptor competition between agonist and antagonist.
A patient is diagnosed with histoplasmosis and will begin taking ketoconazole. What information will the nurse include when teaching this patient about this medication?
- A. Take the medicine twice daily
- B. Take the medication with food
- C. You may consume small amounts of alcohol
- D. You will not need lab tests while taking this drug
Correct Answer: B
Rationale: Ketoconazole absorption improves with food; it's once daily, and alcohol or no labs are incorrect. Ketoconazole should be taken with food.
The drug, which interferes with metabolism of theophylline
- A. Gentamicin
- B. Penicillin
- C. Erythromycin
- D. Sulfonamide
Correct Answer: C
Rationale: Erythromycin inhibits cytochrome P-450, reducing theophylline metabolism.
Beta-blockers decrease nocturnal melatonin release, thereby contributing to sleep disturbances.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Beta-blockers, especially lipophilic ones, reduce melatonin release, potentially causing sleep disturbances.