A nurse is providing teaching for a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse include?

A. "Do not drink alcohol while taking this medication": Disulfiram is a medication used to deter alcohol consumption by producing unpleasant effects, such as nausea, vomiting, and flushing, if alcohol is consumed. Therefore, it is crucial for the client to abstain from alcohol while taking disulfiram to avoid these adverse reactions.

B. "Do not crush this medication before swallowing": While it is generally important not to alter the formulation of medications unless instructed by a healthcare provider or indicated in the medication's instructions, crushing disulfiram is not typically a concern. However, the primary focus of disulfiram therapy is the avoidance of alcohol, rather than specific administration instructions.

C. "Avoid grapefruit juice while taking this medication": Grapefruit juice is known to interact with certain medications by inhibiting cytochrome P450 enzymes in the liver, affecting drug metabolism. However, there is no significant interaction between disulfiram and grapefruit juice. Therefore, this information is not relevant to disulfiram therapy.

D. "Take this medication with food": Disulfiram is typically taken on an empty stomach, as food can interfere with its absorption. Therefore, advising the client to take disulfiram with food is not accurate and may compromise its effectiveness. The primary concern with disulfiram therapy is adherence to abstinence from alcohol.

A. Dystonia - Dystonia presents as sustained or intermittent muscle contractions causing abnormal, often repetitive, movements or postures. It is an acute extrapyramidal side effect of antipsychotic medications like chlorpromazine but typically manifests as sudden-onset muscle spasms rather than involuntary movements of the tongue and face.

B. Tardive dyskinesia - Tardive dyskinesia is a late-appearing movement disorder characterized by involuntary, repetitive movements of the face, tongue, and limbs. It is associated with long-term use of antipsychotic medications like chlorpromazine and typically develops after months to years of treatment.

C. Parkinsonism - Parkinsonism resembles Parkinson's disease and is characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While antipsychotic medications can cause Parkinsonism as an adverse effect, it usually presents with symptoms different from those described in the scenario.

D. Akathisia - Akathisia is characterized by an inner feeling of restlessness and the urge to move, often accompanied by pacing and inability to sit still. It is an acute extrapyramidal side effect of antipsychotic medications but does not manifest as involuntary movements of the tongue and face as described in the scenario.