The barbiturate phenobarbital is prescribed for a patient with epilepsy. While assessing the patient's current medications, the nurse recognizes that interactions may occur with which drugs? (Select all that apply.)
Oral contraceptives
Antihistamines
Warfarin
Opioids
Diuretics
Correct Answer : A,D,E
A. Oral contraceptives: Phenobarbital can decrease the effectiveness of oral contraceptives, increasing the risk of contraceptive failure and unintended pregnancy.
B. Antihistamines: While phenobarbital can induce hepatic enzymes, leading to increased
metabolism of some antihistamines, this interaction is less clinically significant compared to the interactions with oral contraceptives, opioids, and diuretics.
C. Warfarin: Phenobarbital can induce the metabolism of warfarin, potentially reducing its anticoagulant effects and necessitating closer monitoring of international normalized ratio (INR) levels.
D. Opioids: Phenobarbital can increase the metabolism of opioids, leading to reduced analgesic effects and potentially causing inadequate pain control.
E. Diuretics: Phenobarbital can accelerate the metabolism of diuretics, potentially reducing their efficacy and necessitating adjustments in dosage or monitoring of electrolyte levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Acetaminophen is generally considered safe for patients with a history of peptic ulcer disease.
It does not irritate the gastrointestinal mucosa like nonsteroidal anti-inflammatory drugs (NSAIDs).
B. Patients with a history of liver disease should not receive acetaminophen or should use it with caution and under close supervision, as acetaminophen is metabolized in the liver. Liver
impairment can lead to decreased metabolism of acetaminophen, potentially resulting in drug accumulation and hepatotoxicity.
C. Acetaminophen is commonly used to relieve mild to moderate headaches. However, the appropriateness of acetaminophen use in this scenario depends on the patient's overall health status and any contraindications specific to the individual.
D. Acetaminophen is often used to reduce fever. A fever of 101°F (38.3°C) alone does not necessarily contraindicate acetaminophen use, but caution should be exercised in patients with liver disease.
Correct Answer is ["0.6"]
Explanation
To find out how many milliliters (mL) of methylnaltrexone should be administered to achieve a dose of 12 mg, we need to set up a proportion based on the available concentration.
Given:
- Methylnaltrexone concentration: 8 mg per 0.4 mL
- Desired dose: 12 mg
We can set up the proportion as follows:
8 /0.4 = 12 / x
Where ( x ) is the unknown amount of methylnaltrexone in milliliters.
To solve for ( x ), we can cross multiply and then divide:
8x = 0.4 12
8x = 4.8
x = 4.8/8
x = 0.6
Therefore, the nurse should administer 0.6 mL of methylnaltrexone.
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