A patient is taking theophylline. The nurse will monitor for which adverse effects associated with the use of this medication?

Choice A reason: A higher dose of rifampin is not necessary due to oral contraceptives. Rifampin induces hepatic CYP450 enzymes, increasing contraceptive metabolism and reducing their efficacy, not vice versa. Dosing adjustments are not required for rifampin, which remains effective for tuberculosis treatment.

Choice B reason: The incidence of adverse effects is not significantly increased by combining rifampin with oral contraceptives. Rifampin’s side effects, like hepatotoxicity, are independent of contraceptives. The primary concern is rifampin’s induction of contraceptive metabolism, reducing their effectiveness, not an increase in adverse effects.

Choice C reason: Rifampin does not increase the risk of thrombophlebitis in women. Oral contraceptives may increase thromboembolism risk, but rifampin’s enzyme induction reduces contraceptive levels, potentially lowering this risk. Thrombophlebitis is not a known side effect of rifampin, making this statement incorrect.

Choice D reason: Rifampin, a CYP450 enzyme inducer, accelerates the metabolism of oral contraceptives, reducing their plasma levels and effectiveness. This can lead to breakthrough ovulation and unintended pregnancy. Patients should use alternative contraception, like barrier methods, during rifampin therapy to ensure reliable pregnancy prevention.

Choice A reason: Increased appetite is not a common side effect of inhaled corticosteroids due to their minimal systemic absorption. Systemic corticosteroids, like prednisone, stimulate appetite by altering metabolism and increasing hunger signals, but inhaled forms like fluticasone primarily act locally in the lungs, limiting such systemic effects.

Choice B reason: Oral thrush (candidiasis) is a frequent side effect of inhaled corticosteroids. Residual drug in the oral cavity disrupts local microbial flora, promoting Candida albicans overgrowth. Rinsing the mouth after use reduces this risk by removing excess corticosteroid, preventing fungal infections while maintaining anti-inflammatory effects in the airways.

Choice C reason: Hypertension is not typically caused by inhaled corticosteroids, as their systemic absorption is low. Systemic corticosteroids can cause fluid retention and increased blood pressure via mineralocorticoid effects, but inhaled forms like budesonide have minimal impact on cardiovascular parameters, making this an unlikely side effect.

Choice D reason: Constipation is not associated with inhaled corticosteroids. Their action is localized to the respiratory tract, with negligible gastrointestinal effects due to low systemic bioavailability. Systemic corticosteroids may cause metabolic changes, but constipation is not a reported side effect, and inhaled forms do not affect bowel motility.