A patient who is diagnosed with genital herpes is using topical acyclovir, and the nurse is providing instructions about adverse effects. What topic will the nurse include?

Choice A reason: Inhaled corticosteroids, such as fluticasone, are not specifically timed for bedtime to minimize side effects. Their primary effect is local anti-inflammatory action in the airways, with minimal systemic absorption. Timing does not significantly reduce side effects like oral thrush, which is managed by rinsing the mouth. Administration is typically twice daily for consistent asthma control, independent of bedtime.

Choice B reason: Rinsing the mouth after using inhaled corticosteroids is essential to prevent oral candidiasis (thrush). Residual corticosteroid in the oral cavity can disrupt the local microbial balance, promoting fungal overgrowth. Rinsing removes excess drug, reducing infection risk while maintaining the drug’s anti-inflammatory effect in the airways, ensuring safe and effective therapy.

Choice C reason: Weight gain of 5 pounds in a week is not a typical side effect of inhaled corticosteroids due to their minimal systemic absorption. Stopping the medication abruptly could exacerbate asthma symptoms. Significant weight gain is more associated with systemic corticosteroids, which affect metabolism and fluid retention, unlike inhaled formulations.

Choice D reason: Inhaled corticosteroids do not require an empty stomach for effectiveness, as they are delivered directly to the lungs via inhalation. Their local action on airway inflammation is independent of gastrointestinal absorption. Food intake does not influence their pharmacokinetics or therapeutic efficacy, making this instruction irrelevant for inhaled corticosteroid use.

Choice A reason: Drowsiness is not a common adverse effect of chloroquine, an antimalarial drug. Chloroquine inhibits heme polymerization in Plasmodium, with side effects like visual disturbances or dizziness. Drowsiness is more associated with antihistamines or CNS depressants, not chloroquine’s mechanism or pharmacokinetic profile.

Choice B reason: Constipation is not a typical side effect of chloroquine. Its primary adverse effects include gastrointestinal upset, visual toxicity, or neurological symptoms like dizziness. Chloroquine’s action on parasitic metabolism does not significantly affect gastrointestinal motility, making constipation an unlikely reaction to report.

Choice C reason: Dizziness is a known adverse effect of chloroquine, potentially due to its effects on the central nervous system or ototoxicity. Patients should report dizziness, as it may indicate toxicity or neurological involvement, requiring dose adjustment or monitoring to ensure safe antimalarial or anti-inflammatory therapy.

Choice D reason: Insomnia is not a primary adverse effect of chloroquine. While neurological effects like headache or dizziness may occur, insomnia is less common. Chloroquine’s toxicity profile focuses on visual, cardiac, or neurological symptoms, and insomnia is not typically reported, making this less critical to monitor.