A nurse is explaining drug metabolism to a nursing student who asks about glucuronidation. The nurse knows that this is a process that allows drugs to be:

Choice A reason: Theophylline is rarely used due to toxicity risks and less efficacy compared to beta-agonists. Increasing fluticasone dose doesn’t address acute exacerbations, as inhaled corticosteroids act slowly. Oxygen is appropriate, but this regimen lacks rapid-acting bronchodilators, making it inadequate for acute asthma management.

Choice B reason: Four puffs of albuterol via inhaler may be insufficient for severe asthma (90% saturation, wheezes). Theophylline is outdated, and nebulized treatments are more effective in emergencies. Oxygen is needed, but this combination lacks systemic steroids for inflammation, making it less optimal.

Choice C reason: Intravenous glucocorticoids reduce airway inflammation rapidly, nebulized albuterol and ipratropium provide synergistic bronchodilation, and oxygen corrects hypoxia (90% saturation). This aligns with guidelines for acute asthma exacerbations, addressing inflammation, bronchoconstriction, and oxygenation, making it the correct and comprehensive treatment choice.

Choice D reason: Intramuscular glucocorticoids are slower than intravenous for acute asthma. Salmeterol, a long-acting beta-agonist, is inappropriate for acute exacerbations, as it lacks rapid onset. Oxygen is needed, but this regimen doesn’t address immediate bronchoconstriction effectively, making it incorrect for emergency management.

Choice A reason: NSAIDs, like ibuprofen, exacerbate peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) by inhibiting COX-1, reducing protective gastric mucus and increasing acid-related damage. They are contraindicated in these conditions, making this choice incorrect for treatment.

Choice B reason: Antacids neutralize gastric acid, providing rapid symptom relief in PUD and GERD by reducing acid irritation on the esophagus and stomach lining. They are a standard, non-prescription option for mild symptoms, making this a correct choice for managing these conditions.

Choice C reason: Laxatives treat constipation by promoting bowel movements but have no role in PUD or GERD, which involve acid-related damage to the stomach or esophagus. They don’t affect gastric acid or mucosal protection, making this choice incorrect for treatment.

Choice D reason: H2 antagonists, like ranitidine, reduce gastric acid secretion by blocking histamine receptors on parietal cells, promoting ulcer healing and relieving GERD symptoms. They are a mainstay treatment for both conditions, making this a correct choice for effective management.

Choice E reason: Proton pump inhibitors, like omeprazole, strongly inhibit gastric acid production by blocking the proton pump in parietal cells, allowing ulcer healing and reducing GERD symptoms. They are first-line therapy for PUD and GERD, making this a correct choice.