A nurse is reviewing the laboratory results of a client who uses licorice as a CAM product to treat his cough and sore throat. The nurse should expect that licorice may have which of the following effects on his laboratory results?

The correct answer is

A. Aspirin, an antiplatelet agent for cardiovascular prevention.

Choice A reason: Aspirin, an antiplatelet agent for cardiovascular prevention, may interact with garlic and increase the risk of bleeding. This is because garlic has antiplatelet and anticoagulant properties that may enhance the effects of aspirin and other drugs that slow blood clotting.

Choice B reason: Simvastatin, a statin for hyperlipidemia, may not interact with garlic significantly. This is because garlic does not appear to affect the metabolism or absorption of simvastatin or other statins. However, some studies suggest that garlic may have additive lipid-lowering effects when combined with statins.

Choice C reason: Metoprolol, a beta blocker for hypertension, may not interact with garlic significantly. This is because garlic does not appear to affect the metabolism or absorption of metoprolol or other beta blockers. However, some studies suggest that garlic may have additive blood pressure-lowering effects when combined with beta-blockers.

Choice D reason: All of the above is not a correct answer because only aspirin may interact with garlic in a clinically relevant way. Simvastatin and metoprolol may not have significant interactions with garlic, although they may have additive effects on lipid levels and blood pressure, respectively.

The correct answer is

A. Decrease in serum potassium level and increase in serum sodium level.

Choice A reason: A decrease in serum potassium level and an increase in serum sodium level is a possible effect of licorice on the client's laboratory results. This is because licorice contains glycyrrhizin, a compound that can inhibit the enzyme 11-beta-hydroxysteroid dehydrogenase, which converts cortisol to cortisone. This leads to increased cortisol levels, which can mimic the effects of aldosterone, a hormone that regulates sodium and potassium balance. As a result, licorice can cause sodium and water retention, hypertension, and hypokalemia (low potassium levels) in some people.

Choice B reason: An increase in serum potassium level and decrease in serum sodium level is not a likely effect of licorice on the client's laboratory results. This is because licorice tends to have the opposite effect, as explained above.

Choice C reason: A decrease in serum calcium level and an increase in serum magnesium level is not a consistent or conclusive effect of licorice on the client's laboratory results. This is because the evidence for the effects of licorice on calcium and magnesium metabolism is limited and conflicting. Some studies suggest that licorice may lower calcium levels by increasing urinary calcium excretion, while others suggest that licorice may increase calcium levels by enhancing intestinal calcium absorption. Similarly, some studies suggest that licorice may lower magnesium levels by increasing urinary magnesium excretion, while others suggest that licorice may increase magnesium levels by enhancing intestinal magnesium absorption.

Choice D reason: Increase in serum calcium level and decrease in serum magnesium level is not a common or expected effect of licorice on the client's laboratory results. This is because licorice does not have a clear or consistent impact on calcium and magnesium metabolism, as mentioned above.