Fluticasone (Flonase) a nasal glucocorticoid has been prescribed for a client with allergic rhinitis. The nurse teaches the client which is the most common side effect of continuous use.

Montelukast is a medicine used to treat and prevent asthma and allergic rhinitis. It can cause some side effects, such as stomach pain, headache, cough, or fever. However, some side effects are more serious and need to be reported to the provider.

According to the sources I found, the most serious side effect of montelukast that should be reported to the provider is depression. Depression is a mental health condition that can affect your mood, thoughts, and behavior. It can cause symptoms such as feeling sad, hopeless, or worthless; losing interest in activities you used to enjoy; having trouble sleeping or concentrating; or having thoughts of harming yourself or others.

Montelukast has been linked to neuropsychiatric events, such as agitation, aggression, sleep disturbances, suicidal thoughts and behavior (including suicide). The mechanisms underlying these events are not well understood, but they can occur at any time during treatment. Therefore, patients and caregivers should be alert for changes in behavior or new neuropsychiatric symptoms when taking montelukast. If these occur, they should discontinue montelukast and contact a healthcare provider immediately.

The other options are not listed as serious side effects of montelukast that need to be reported to the provider. Constipation, blurred vision, and palpitations are possible side effects of other medicines used to treat asthma or allergic rhinitis, such as corticosteroids, antihistamines, or beta-agonists. However, they are not specific to montelukast and may not be related to its use.

White coating in the mouth: A white coating in the mouth could be a sign of a fungal infection such as oral thrush. Fluticasone, which is a corticosteroid, can increase the risk of developing fungal infections. Therefore, the nurse should instruct the client to report any signs of oral thrush or other unusual changes in the mouth, such as white patches or discomfort, to the provider.
Prompt identification and treatment of oral thrush are necessary to prevent its progression and ensure effective management of the client's condition.
Dry oral mucous membranes: Dry oral mucous membranes are not typically associated with fluticasone/salmeterol use. However, if the client experiences persistent or severe dryness in the mouth or any other unusual oral symptoms, it should be reported to the provider. Dry mouth can sometimes occur as a side effect of medications or indicate other underlying issues that need to be addressed.
Sedation: Sedation is not a common side effect of fluticasone/salmeterol. If the client experiences excessive drowsiness or sedation that interferes with their daily activities, it may be important to report this to the provider. While sedation is not a typical adverse effect of this medication, individual responses can vary, and it is essential to ensure appropriate monitoring and management.
Increased appetite is not typically associated with fluticasone/salmeterol use. It is not a commonly reported adverse effect of the medication. However, if the client experiences significant and unexplained changes in appetite that are concerning or persistent, it may be worth mentioning to the provider during a follow-up appointment or as part of ongoing monitoring.