A patient will be starting therapy with a corticosteroid. The nurse reviews the prescriber's orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?

Antibiotics

Nonsteroidal anti-inflammatory drugs

Opioid analgesics

Antidepressants

Answer and Explanation

The Correct Answer is B

Choice A reason: Antibiotics are not likely to interact with corticosteroids, unless they are aminoglycosides, which can increase the risk of hypokalemia. However, most antibiotics do not affect the metabolism or efficacy of corticosteroids.

Choice B reason: Nonsteroidal anti-inflammatory drugs (NSAIDs) can interact with corticosteroids, as they both have anti-inflammatory and immunosuppressive effects. This can increase the risk of gastrointestinal bleeding, ulceration, and perforation. Therefore, the nurse should monitor the patient for signs of bleeding and advise the patient to avoid taking NSAIDs with corticosteroids.

Choice C reason: Opioid analgesics are not likely to interact with corticosteroids, unless they are codeine, which can decrease the clearance of corticosteroids. However, most opioid analgesics do not affect the metabolism or efficacy of corticosteroids.

Choice D reason: Antidepressants are not likely to interact with corticosteroids, unless they are monoamine oxidase inhibitors (MAOIs), which can increase the risk of hypertension and hypertensive crisis. However, most antidepressants do not affect the metabolism or efficacy of corticosteroids.

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Correct Answer is A

Explanation

The correct answer is a. Alcohol.

Choice A: Alcohol

Reason: Alcohol can significantly affect blood glucose levels in patients taking glimepiride. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on the amount and frequency of alcohol consumption. Alcohol can enhance the blood sugar-lowering effect of glimepiride, leading to a dangerous drop in blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, weakness, and in severe cases, loss of consciousness. Therefore, it is advised to avoid alcohol while taking glimepiride.

Choice B: Milk

Reason: There are no known interactions between glimepiride and milk. Milk does not affect the absorption or efficacy of glimepiride. Therefore, it is generally safe to consume milk while taking this medication.

Choice C: Grapefruit juice

Reason: Grapefruit juice might theoretically increase the levels of drugs metabolized by CYP2C9, including glimepiride, due to its potential to inhibit CYP2C9 enzymes. However, this interaction has not been reported in humans and is considered unlikely to have a significant clinical impact. Therefore, grapefruit juice is not a major concern for patients taking glimepiride.

Choice D: Coffee

Reason: Coffee and other caffeinated beverages may increase blood sugar levels, which can counteract the effects of glimepiride. However, this interaction is not as significant as the interaction with alcohol. It is generally advised to monitor blood sugar levels and consume coffee in moderation while taking glimepiride.

A. Take the bronchodilator inhaler first. B. Take the corticosteroid inhaler first. C. Take these two drugs at least 2 hours apart. D. It does not matter which inhaler you use first.

Correct Answer is A

Explanation

Choice A reason: Taking the bronchodilator inhaler first will help to open up the airways and make it easier for the corticosteroid inhaler to reach the lungs and reduce inflammation. This will improve the effectiveness and safety of the inhalers.

Choice B reason: Taking the corticosteroid inhaler first may not be as effective as taking the bronchodilator inhaler first, because the airways may be constricted and prevent the corticosteroid from reaching the lungs. This may reduce the anti-inflammatory effect of the corticosteroid and increase the risk of side effects.

Choice C reason: Taking these two drugs at least 2 hours apart is not necessary and may not be practical for the patient. The bronchodilator and the corticosteroid can be taken together, as long as the bronchodilator is taken first.

Choice D reason: It does matter which inhaler the patient uses first, because the order of the inhalers can affect their efficacy and safety. The patient should always use the bronchodilator inhaler first, followed by the corticosteroid inhaler.

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A patient will be starting therapy with a corticosteroid. The nurse reviews the prescriber's orders and notes that an interaction may occur if the corticosteroid is taken with which of these drug classes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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