A nurse is providing discharge education to a patient with a new prescription for Baclofen. Which of the following instructions should the nurse include?

"Avoid alcohol while taking this medication as it may increase drowsiness."

"You can abruptly stop taking this medication if you don't notice improvement."

"Baclofen doesn't cause drowsiness, so you can continue your normal activities without any restrictions."

"Take this medication only when you experience muscle spasms:"

Answer and Explanation

The Correct Answer is A

A. "Avoid alcohol while taking this medication as it may increase drowsiness.": Baclofen is a central nervous system depressant and can cause sedation. Alcohol can intensify this effect, increasing the risk of severe drowsiness, dizziness, or respiratory depression.
B. "You can abruptly stop taking this medication if you don't notice improvement.": Abrupt discontinuation of Baclofen can lead to withdrawal symptoms such as hallucinations, seizures, and rebound spasticity. The medication should be tapered under medical supervision.
C. "Baclofen doesn't cause drowsiness, so you can continue your normal activities without any restrictions.": Baclofen often causes drowsiness and dizziness, especially when therapy is initiated. Patients should be cautious with activities requiring alertness, such as driving.
D. "Take this medication only when you experience muscle spasms:": Baclofen is typically taken on a regular schedule to maintain therapeutic levels and control muscle spasms continuously. It is not used on an as-needed basis.

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Correct Answer is A

Explanation

A. "All antipsychotic drugs carry an equal risk of causing movement-related side effects.": First-generation antipsychotics like Haloperidol are more likely to cause extrapyramidal symptoms due to their potent dopamine D2 receptor blockade. Second-generation antipsychotics carry a lower risk, making this statement inconsistent with clinical evidence.
B. "These side effects happen because this drug blocks dopamine in certain parts of my brain.": Extrapyramidal symptoms are primarily due to dopamine blockade in the nigrostriatal pathway, which regulates motor control. Interference in this region leads to tremors, rigidity, and other movement disorders.
C. "Taking other drugs with my Haloperidol can increase the risk of extrapyramidal symptoms.": Concurrent use of medications that also affect dopamine pathways or have sedative effects can increase the likelihood of developing EPS. Drug interactions are a significant factor in overall risk.
D. "Tardive dyskinesia occurs with prolonged use of an antipsychotic drug.": Long-term use of dopamine-blocking agents, especially at high doses, can lead to tardive dyskinesia. This condition involves involuntary movements and may be irreversible, particularly in older adults.

A. The safe and toxic plasma levels of the drug are very close to each other B. The drug has a wide range between its effective dose and toxic dose C. The drug requires infrequent monitoring of serum levels D. The drug has a high margin of safety in clinical use

Correct Answer is A

Explanation

A. The safe and toxic plasma levels of the drug are very close to each other: A narrow therapeutic index means there is a small margin between the minimum effective concentration and the toxic concentration. Small dosing errors or individual variations in metabolism can lead to toxicity or subtherapeutic effects, requiring close monitoring.
B. The drug has a wide range between its effective dose and toxic dose: This describes a drug with a wide therapeutic index, which allows more flexibility in dosing without significant risk of toxicity. Narrow therapeutic index drugs are the opposite and require precise dosing.
C. The drug requires infrequent monitoring of serum levels: Medications with a narrow therapeutic index often require frequent serum level monitoring to ensure that the drug stays within the safe and effective range. This helps reduce the risk of adverse effects or treatment failure.
D. The drug has a high margin of safety in clinical use: A high margin of safety is characteristic of drugs with a wide therapeutic index. Narrow therapeutic index drugs have a low safety margin and pose higher risks if not carefully dosed and monitored.

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A nurse is providing discharge education to a patient with a new prescription for Baclofen. Which of the following instructions should the nurse include?

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