The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy.
Which other medication or medication class, if ordered, would be a potential interaction concern?
Proton pump inhibitors
Calcium channel blockers
Loop diuretics
Phenytoin
The Correct Answer is C
Choice A rationale:
Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.
However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.
Choice B rationale:
Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.
Choice C rationale:
The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.
Choice D rationale:
Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Double vision is not a common side effect of quinolones. Quinolones are a type of antibiotic that are used to kill or inhibit the growth of bacteria. While they can have side effects, double vision is not typically one of them.
Choice B rationale:
Tendonitis and tendon rupture are known adverse effects of quinolones. These antibiotics can very rarely cause long-lasting, disabling, and potentially irreversible side effects, sometimes affecting multiple systems, organ classes, and senses. One of these side effects is damage to the tendons, which can manifest as tendonitis (inflammation of the tendon) or even tendon rupture. This is particularly a concern for people older than 60 years and for those with renal impairment or solid-organ transplants because they are at a higher risk of tendon injury.
Choice C rationale:
Neuralgia, or nerve pain, is not a common side effect of quinolones. While these antibiotics can affect the nervous system and cause side effects such as peripheral neuropathy and central nervous system effects, neuralgia is not typically reported.
Choice D rationale:
Hypotension, or low blood pressure, is not typically associated with the use of quinolones. These antibiotics can have various side effects, but a significant drop in blood pressure is not commonly reported.
Correct Answer is A
Explanation
Choice A rationale:
Zidovudine, also known as AZT, is a medication used for the treatment of human immunodeficiency virus (HIV) infection. One of the major dose-limiting toxic effects of Zidovudine is hematologic toxicity, which manifests clinically as anemia, neutropenia, and sometimes as platelet deficits with onset after several weeks of treatment. This hematologic toxicity is essentially a form of bone marrow suppression. Therefore, bone marrow suppression is the dose-limiting adverse effect of zidovudine therapy.
Choice B rationale:
Retinitis is not a known dose-limiting adverse effect of zidovudine. While zidovudine has a range of side effects, retinitis is not commonly associated with its use.
Choice C rationale:
Renal toxicity is not a known dose-limiting adverse effect of zidovudine. While zidovudine can have various side effects, renal toxicity is not typically one of them.
Choice D rationale:
Hepatotoxicity is not the dose-limiting adverse effect of zidovudine. While severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of zidovudine, it is not considered the dose-limiting adverse effect. The dose-limiting adverse effect is more specifically related to hematologic toxicity, which includes bone marrow suppression.
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