A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?

During an acute asthma attack, the airways become narrowed and inflamed, leading to symptoms such as wheezing, shortness of breath, and chest tightness. Short-acting beta2 agonists like Albuterol are the first-line medication for relieving acute asthma symptoms. They work by quickly relaxing the smooth muscles in the airways, resulting in bronchodilation and improved airflow. Albuterol provides rapid relief of symptoms and is often administered via inhalation.
A. Long-acting beta2 agonists (e.g., salmeterol) are typically used as maintenance therapy for long-term control of asthma symptoms, rather than for immediate relief during an acute attack.
C. Corticosteroids (e.g., fluticasone) are anti-inflammatory medications that are often prescribed for asthma, but they are more commonly used as part of a long-term management plan and may not provide immediate relief during an acute attack.
D. Anticholinergics (e.g., ipratropium) are sometimes used in combination with short-acting beta2 agonists for acute asthma exacerbations, but they are not typically the initial treatment choice for an acute asthma attack.

Montelukast is a medicine used to treat and prevent asthma and allergic rhinitis. It can cause some side effects, such as stomach pain, headache, cough, or fever. However, some side effects are more serious and need to be reported to the provider.

According to the sources I found, the most serious side effect of montelukast that should be reported to the provider is depression. Depression is a mental health condition that can affect your mood, thoughts, and behavior. It can cause symptoms such as feeling sad, hopeless, or worthless; losing interest in activities you used to enjoy; having trouble sleeping or concentrating; or having thoughts of harming yourself or others.

Montelukast has been linked to neuropsychiatric events, such as agitation, aggression, sleep disturbances, suicidal thoughts and behavior (including suicide). The mechanisms underlying these events are not well understood, but they can occur at any time during treatment. Therefore, patients and caregivers should be alert for changes in behavior or new neuropsychiatric symptoms when taking montelukast. If these occur, they should discontinue montelukast and contact a healthcare provider immediately.

The other options are not listed as serious side effects of montelukast that need to be reported to the provider. Constipation, blurred vision, and palpitations are possible side effects of other medicines used to treat asthma or allergic rhinitis, such as corticosteroids, antihistamines, or beta-agonists. However, they are not specific to montelukast and may not be related to its use.