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Select whether the following drugs carry a risk of causing hyperkalemia or hypokalemia:

A.

Losartan

B.

Furosemide

C.

Spironolactone

D.

Lisinopril

E.

Digoxin

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}

  • Losartan: As an angiotensin II receptor blocker (ARB), losartan reduces aldosterone secretion, leading to decreased potassium excretion and potential hyperkalemia, especially in patients with renal impairment or those on potassium supplements.
  • Furosemide: This loop diuretic promotes the excretion of sodium and potassium in the urine, commonly resulting in hypokalemia. Patients on furosemide often require potassium monitoring or supplementation.
  • Spironolactone: A potassium-sparing diuretic and aldosterone antagonist, spironolactone reduces potassium excretion in the distal nephron. This can lead to hyperkalemia, particularly when used with other potassium-elevating drugs.
  • Lisinopril: An ACE inhibitor that blocks the conversion of angiotensin I to II, reducing aldosterone levels and thereby decreasing potassium excretion. This places patients at risk for hyperkalemia.
  • Digoxin: This cardiac glycoside may cause hypokalemia indirectly by increasing sensitivity to potassium shifts. Additionally, low potassium levels enhance digoxin toxicity, so maintaining normal potassium is critical during therapy.


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Related Questions

Correct Answer is A

Explanation

A. They are the nonproprietary names of drugs: Generic names are standardized names assigned by an official body such as the United States Adopted Names (USAN) Council. They are not owned by any drug company and are used universally across brands, making them the nonproprietary identifiers of medications.
B. They are unique to each pharmaceutical company: This describes brand or trade names, not generic names. Brand names vary between manufacturers, but the generic name remains the same regardless of who produces the medication.
C. They are not used on the NCLEX: Generic names are primarily used on the NCLEX to test nursing knowledge. Nurses are expected to recognize generic names, as they are the standard reference in clinical practice and reduce confusion associated with multiple brand names.
D. They are always capitalized and trademarked: Generic names are written in lowercase and are not trademarked. In contrast, brand names are capitalized and legally protected as trademarks by pharmaceutical companies.

Correct Answer is A

Explanation

A. "If my pain persists, I can safely increase the dose to 1500 mg every 4–6 hours.": This dose exceeds the maximum safe limit for acetaminophen. The recommended adult dose is no more than 1000 mg per dose and 4000 mg per day. Exceeding this can lead to serious hepatotoxicity, especially with prolonged use or preexisting liver conditions.
B. "I should use caution when taking acetaminophen with warfarin as it may affect my INR levels.": Acetaminophen can increase the anticoagulant effect of warfarin, possibly elevating INR and increasing the risk of bleeding. Regular monitoring is recommended when both drugs are used concurrently.
C. "I need to be cautious when taking other medications that may contain acetaminophen.": Many over-the-counter medications, such as cold and flu remedies, also contain acetaminophen. Accidental overdose can occur if this is not considered when calculating total daily intake.
D. "I should contact my healthcare provider if I experience yellowing of the skin or eyes.": Jaundice may be a sign of liver damage or failure due to acetaminophen toxicity. Early recognition of this symptom is critical for preventing serious complications.

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