A nurse is caring for a client who is receiving tobramycin. The nurse should monitor the client for which of the following adverse effects?

A. Rash. A rash while taking allopurinol can indicate a serious hypersensitivity reaction, including Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These life-threatening conditions involve widespread skin blistering, mucosal involvement, and systemic symptoms. Immediate discontinuation of allopurinol and medical intervention are required to prevent severe complications.

B. Diarrhea. Mild gastrointestinal disturbances, including diarrhea, are common with allopurinol use. While bothersome, diarrhea is not life-threatening and can often be managed by adjusting the dose or taking the medication with food. It does not require immediate discontinuation unless severe or persistent.

C. Nausea. Nausea is a common, mild side effect of allopurinol that usually resolves with time or by taking the medication after meals. It is not an emergency and does not require urgent intervention unless accompanied by other concerning symptoms such as vomiting or severe abdominal pain.

D. Metallic taste in mouth. A metallic taste can occur with allopurinol use but is not harmful. It is a minor side effect that does not indicate toxicity or severe adverse reactions. Clients can be reassured that this effect is temporary and not a reason to stop the medication.

A. Drowsiness. Alendronate, a bisphosphonate used to treat osteoporosis, does not cause drowsiness. It primarily affects bone metabolism rather than the central nervous system. If a client experiences drowsiness, it is likely due to another cause rather than the medication itself.

B. Dyskinesia. Dyskinesia refers to involuntary movements often associated with neurological disorders or medications affecting dopamine, such as antipsychotics or Parkinson’s medications. Alendronate does not affect dopamine or the nervous system, making dyskinesia an unlikely adverse effect.

C. Musculoskeletal pain. A known side effect of alendronate is musculoskeletal pain, including bone, joint, and muscle discomfort. This occurs due to the medication’s effects on bone remodeling and turnover. While mild pain may resolve on its own, persistent or severe pain should be reported to the provider as it may require dose adjustment or discontinuation.

D. Weight gain. Alendronate does not cause weight gain. It primarily acts on bone tissue to inhibit osteoclast-mediated bone resorption, preventing further bone loss. Clients experiencing unexplained weight gain should be evaluated for other potential causes, such as metabolic conditions or lifestyle factors.