Mrs. Oza, age 69, has hypertension and has one functioning kidney. She loves chocolates and enjoys an alcoholic beverage twice a week. Her hobby is gardening and she goes for long walks despite having arthritis. Which one of the following pieces of information is likely to have the greatest significance if she is prescribed vancomycin?

She only has one functioning kidney

She remains outdoors for long periods of time

She has hypertension

She enjoys an alcoholic beverage twice a week

Answer and Explanation

The Correct Answer is A

A. She only has one functioning kidney:

This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.

B. She remains outdoors for long periods of time:

While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.

C. She has hypertension:

Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.

D. She enjoys an alcoholic beverage twice a week:

While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.

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Correct Answer is C

Explanation

A. Ibuprofen:

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to relieve pain and reduce inflammation. There are no significant interactions reported between erythromycin and ibuprofen.

B. Lasix (Furosemide):

Lasix is a diuretic medication used to treat fluid retention (edema) and high blood pressure. There are no significant interactions reported between erythromycin and furosemide.

C. Lovastatin:

Lovastatin is a statin medication used to lower cholesterol levels. Erythromycin can increase the levels of lovastatin in the blood by inhibiting its metabolism through the CYP3A4 enzyme. This can lead to an increased risk of statin-related side effects, including muscle pain and weakness, and in rare cases, rhabdomyolysis.

D. Lisinopril:

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure and heart failure. There are no significant interactions reported between erythromycin and lisinopril.

A. never take with prescription medications B. use only one herbal preparation at a time C. take less than the recommended dose initially D. check with a reputable pharmacist

Correct Answer is B

Explanation

A. Never take with prescription medications:

This statement is not accurate. Many herbal products can interact with prescription medications, potentially leading to adverse effects or reduced efficacy. However, avoiding taking herbal products with prescription medications altogether may not be practical or necessary in all cases. Instead, it's essential to assess for potential interactions and consult with healthcare professionals.

B. Use only one herbal preparation at a time:

This is the correct approach. Using only one herbal preparation at a time allows for better identification of any allergic reactions or adverse effects. If multiple herbal products are taken simultaneously, it can be challenging to determine which product is causing a particular reaction. Starting with one product also simplifies monitoring for efficacy and safety.

C. Take less than the recommended dose initially:

While starting with a lower dose initially may be a prudent approach for some individuals, it is not necessarily the best way to identify allergic or adverse reactions. Taking less than the recommended dose may not provide a full assessment of the product's effects and may not adequately identify potential adverse reactions.

D. Check with a reputable pharmacist:

Consulting with a reputable pharmacist is essential for obtaining information about herbal products, including potential interactions, side effects, and recommended dosages. While a pharmacist can provide valuable guidance, they may not be present during the initial use of the herbal product to monitor for adverse reactions directly.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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