A client with hepatitis C has been experiencing symptoms of gastroesophageal reflux.
What H antagonist would be most appropriate for this client’s needs?
Nizatidine.
Ranitidine.
Cimetidine.
Famotidine.
The Correct Answer is D
Famotidine is a histamine type 2 receptor antagonist (H blocker) which is commonly used for treatment of acid-peptic disease and heartburn. Famotidine has been linked to rare instances of clinically apparent acute liver injury, but it is less likely to cause hepatotoxicity than cimetidine, another H blocker. Famotidine also has fewer drug interactions than cimetidine.
Choice A is wrong because nizatidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Nizatidine has not been linked to cases of clinically apparent liver injury, but it has not been widely used.
Choice B is wrong because ranitidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Ranitidine has also been associated with rare instances of clinically apparent liver injury, some of which were fatal or required liver transplantation.
Choice C is wrong because cimetidine is another H blocker that can cause mild and transient serum aminotransferase elevations.
Cimetidine has also been implicated in several cases of clinically apparent acute liver injury, some of which were severe and led to acute liver failure and death.
Cimetidine also has many drug interactions due to its inhibition of cytochrome P enzymes.
Normal ranges for serum aminotransferases are 7 to 56 U/L for alanine aminotransferase (ALT) and 10 to 40 U/L for as
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The client should avoid taking aspirin while taking corticosteroids because of the potential drug-drug interaction between them. This interaction may cause a reduction in the blood levels of aspirin and decrease its effectiveness. It may also increase the risk of gastrointestinal side effects such as inflammation, bleeding, ulceration, and perforation.
Choice A is wrong because dimenhydrinate is an antihistamine that is used to prevent and treat nausea, vomiting, and dizziness.
It does not have a significant interaction with corticosteroids.
Choice C is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain, inflammation, and fever.
It has a similar interaction with corticosteroids as aspirin, but it is less potent and less likely to cause bleeding.
Choice D is wrong because famotidine is a histamine-2 receptor antagonist that is used to treat and prevent ulcers, gastroesophageal reflux disease (GERD), and other conditions that cause excess stomach acid.
It does not have a significant interaction with corticosteroids.
Correct Answer is B
Explanation
This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.
Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.
The dose adjustment should be based on serum theophylline levels and clinical response.
Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.
Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.
Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.
The dose of theophylline should be carefully titrated according to serum levels and clinical response.
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