A client currently prescribed a medication highly metabolized by the CYP 450 recently began smoking due to a stressful life event. True or False: The level of medication will increase in this client.

True

False

Answer and Explanation

The Correct Answer is A

CYP 450 enzymes are responsible for the metabolism of many drugs. Smoking can induce certain CYP 450 enzymes, particularly CYP1A2, which leads to an increase in the metabolism of drugs that are substrates of this enzyme. When a person begins smoking, the induction of these enzymes can cause drugs to be metabolized more quickly, which typically results in lower drug levels in the body. However, the statement asks whether the level of medication will increase in this client, and since smoking induces enzyme activity, it would typically lead to decreased, not increased, drug levels. However, in the context of drug-drug interactions and other metabolic pathways, the metabolism rate could be altered in ways that might increase or affect the therapeutic response.

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Correct Answer is C

Explanation

A) Cerebral Vascular Accident (CVA): While a history of a CVA (stroke) is important to consider when prescribing medications, ondansetron is not contraindicated for clients with a history of CVA. The nurse would need to assess the client’s overall neurological status and risk factors but this condition is not an immediate concern for ondansetron use.

B) Depression: Ondansetron is not typically contraindicated in patients with depression. However, the nurse should be mindful of the potential for interactions with other medications the client may be taking for depression, but there is no direct contraindication between ondansetron and depression itself.

C) Glaucoma: This is the most concerning finding. Ondansetron can increase the risk of complications in clients with glaucoma, particularly narrow-angle glaucoma. Ondansetron has some serotonin receptor-blocking properties that can cause dilation of the pupil, which could increase intraocular pressure in clients with glaucoma. Therefore, this condition would require careful monitoring, and the nurse would need to consult with the healthcare provider before administering ondansetron to a client with glaucoma.

D) Congestive Heart Failure (CHF): While patients with CHF need to be monitored for fluid balance, ondansetron is not contraindicated in clients with CHF. The primary concern in these patients would be potential fluid retention or electrolyte imbalances, but this is generally not a direct concern for the administration of ondansetron itself.

A. Low albumin B. Renal disease C. Hepatic disease D. An elevated gastric pH

Correct Answer is A

Explanation

A) Low albumin: This factor has the most impact on the pharmacokinetic phase of distribution. Albumin is a key protein in the blood that binds to many medications. When albumin levels are low, fewer drug molecules will be bound, leading to an increased concentration of free (unbound) drug in the bloodstream. This can result in enhanced drug effects or toxicity, as the unbound drug is pharmacologically active and more readily able to cross cell membranes.

B) Renal disease: While renal disease can impact drug elimination and excretion, it does not have as direct an effect on the distribution phase of pharmacokinetics. Renal function primarily affects the clearance of drugs from the body rather than how the drug is distributed within the tissues.

C) Hepatic disease: Hepatic disease can affect the metabolism of drugs and their clearance, but it does not directly affect the distribution phase. While the liver is involved in metabolizing drugs, it is the ability to clear or process the drug that is most influenced, rather than its distribution to tissues.

D) An elevated gastric pH: Elevated gastric pH (which can occur with antacid use or in certain conditions) can affect the absorption of some medications but has minimal direct impact on the distribution phase of pharmacokinetics. Distribution is primarily concerned with how a drug moves from the bloodstream into tissues, and this is more influenced by factors like blood flow, protein binding, and the drug's lipophilicity, rather than the pH of the stomach.

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A client currently prescribed a medication highly metabolized by the CYP 450 recently began smoking due to a stressful life event. True or False: The level of medication will increase in this client.

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

Explanation

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