A nurse is caring for a client who is taking fluticasone due to chronic allergies. The nurse should monitor the client for which of the following adverse effects?

A. Inhibits the production of leukotrienes and histamine, preventing further asthma attacks: This statement is misleading. Omalizumab does not directly inhibit the production of leukotrienes or histamine; rather, it works by targeting IgE, which is involved in the allergic response.

B. Inhibits mast cells from releasing histamine, preventing further asthma attacks: While omalizumab does reduce the overall allergic response, it does so by binding to IgE rather than directly inhibiting mast cell activity. Therefore, this description does not accurately represent its primary mechanism of action.

C. Selectively binds to IgE, reducing allergic mediators and asthma attacks: This statement correctly describes the mechanism of action of omalizumab. By binding to immunoglobulin E (IgE), omalizumab prevents IgE from attaching to mast cells and basophils, thus reducing the release of allergic mediators that contribute to asthma attacks.

D. Stimulates alpha-adrenergic receptors to assist in reduction of allergic-related symptoms: This statement is incorrect. Omalizumab does not stimulate alpha-adrenergic receptors; such action is associated with certain bronchodilators. Omalizumab specifically targets IgE to mitigate allergic responses.

A) Liver injury: Zafirlukast (Accolate) has been associated with the risk of liver injury. It is important for clients to be informed about this potential adverse effect, as it may require monitoring of liver function tests during treatment. Symptoms of liver injury, such as jaundice, dark urine, or severe fatigue, should prompt clients to seek medical attention.

B) Bradycardia: Bradycardia is not a commonly associated adverse effect of zafirlukast. This medication primarily works as a leukotriene receptor antagonist and does not typically affect heart rate significantly. Clients should be aware of other more relevant side effects rather than bradycardia.

C) Renal failure: Renal failure is not a known adverse effect of zafirlukast. While kidney function should always be monitored in patients taking various medications, zafirlukast specifically does not have a direct association with renal failure.

D) Bronchoconstriction: While bronchoconstriction is a concern in asthma management, zafirlukast is designed to prevent bronchoconstriction by blocking leukotriene receptors. Therefore, it is not an adverse effect of the medication. In fact, its purpose is to help reduce the incidence of bronchoconstriction and improve asthma control.