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.
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Related Questions
Correct Answer is B
Explanation
A. Signs of bone marrow depression are not typically associated with antiepileptic drugs. This adverse effect is more commonly seen with medications such as chemotherapy agents.
B. Increased risk of suicidal thoughts and behaviors is a well-documented concern with antiepileptic drugs, particularly when used for psychiatric indications or in certain patient populations. The FDA has issued warnings regarding this risk, and healthcare providers should monitor patients for changes in mood, behavior, and suicidal ideation.
C. While some antiepileptic drugs may have cardiovascular effects, such as prolongation of the QT interval, the FDA warning specifically highlights the risk of suicidal thoughts and behaviors rather than cardiovascular events like strokes.
D. Indications of drug addiction and dependency are not typically associated with antiepileptic drugs. These medications are not central nervous system depressants and do not produce the euphoria or withdrawal symptoms characteristic of addictive substances.
Correct Answer is D
Explanation
A. Fever: Fever is not a common adverse effect of haloperidol.
B. Intractable hiccups: While hiccups can occur as a side effect of some medications, they are not a commonly reported adverse effect of haloperidol.
C. Excessive salivation: Excessive salivation is not a typical adverse effect of haloperidol.
D. Extrapyramidal symptoms: Haloperidol, as a first-generation antipsychotic, is known to cause extrapyramidal symptoms such as dystonia, akathisia, parkinsonism, and tardive dyskinesia. Monitoring for these adverse effects is essential during treatment with haloperidol.
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