Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?
- A. Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.
- B. Additive antimuscarinic effects may occur with antihistamines.
- C. Cholinergic blockers may decrease the sedative effects of hypnotics.
- D. Cholinergic blockers are contraindicated with antipsychotics.
Correct Answer: B
Rationale: Additive antimuscarinic effects with antihistamines can enhance side effects like sedation.
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The patient asks the nurse, Is it safe to take over-the-counter (OTC) medications with prescription medications? What is the nurse's best response?(Select one that does not apply.)
- A. OTC medications can interact with prescription medications.
- B. It is important to tell your doctor all medications you take, including OTC.
- C. OTC medications could mask or hide signs and symptoms of a disease.
- D. You should avoid taking any OTC medication when taking prescription drugs.
Correct Answer: D
Rationale: OTC medications can interact with prescription medications or other OTC so it is always important to consult your pharmacist and provider for advice. To provide the most accurate instruction, the health care provider must know all medications taken including dietary supplements, OTC, and prescription. OTC medications could mask or hide symptoms of a disease so it is always important to consult a physician if symptoms persist. OTC medications are not prohibited when taking prescription drugs as long as no drug interaction occurs. How an OTC will impact a prescription medication varies depending on the medications involved, so it is incorrect to say it will make the prescription drug more effective.
The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will expect the provider to order which drug?
- A. Isoniazid (INH)
- B. Pyrazinamide
- C. Rifampin (Rifadin)
- D. Streptomycin
Correct Answer: A
Rationale: INH is the prophylactic standard for TB contacts; other drugs aren't typically used alone for this. INH is the drug of choice for prophylactic treatment of patients who have had close contact with a patient who has tuberculosis.
Which of the following statements is FALSE?
- A. Selenium sulfide is used to treat seborrheic dermatitis of scalp
- B. Gamma-benzen hexachloride is effective against scabies
- C. Psoralens are used in the treatment of vitiligo
- D. Tetannic dioxide is an absorbent sunscreen
Correct Answer: D
Rationale: Titanium dioxide is a reflective, not absorbent, sunscreen.
The nurse is preparing to administer Lanoxin to a patient on the telemetry unit. In addition to understanding the patient's diagnosis, the nurse must also know which characteristic(s) of the medication?(Select one that does not apply.)
- A. Chemical composition
- B. Adverse effects
- C. Expected actions
- D. Contraindications for use
Correct Answer: A
Rationale: The nurse must understand the individual patient's diagnosis and symptoms that correlate with the rationale for drug use. The nurse should also know why a medication is ordered, expected actions, usual dosing, proper dilution, route and rate of administration, adverse effects, and contraindications for the use of a particular drug. It is not required that the nurse know the chemical composition of the medication prior to administration.
When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs:
- A. Omeprazole, a proton pump inhibitor
- B. Combined oral contraceptives
- C. Diphenhydramine, an antihistamine
- D. Warfarin, an anticoagulant
Correct Answer: D
Rationale: NSAIDs increase bleeding risk with warfarin; interactions with PPIs or contraceptives are less significant.