The nurse is counseling a woman who will be starting rifampin. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?

Choice A reason: Antiviral drugs are not solely for palliative care. They inhibit viral replication, reducing viral load and disease severity, as with acyclovir for herpes. While some provide symptomatic relief, many target specific viral processes, aiming for virologic suppression or cure, not just palliation.

Choice B reason: Antiviral drugs, like acyclovir, inhibit viral replication (e.g., DNA polymerase), but some, like chemotherapy agents, can affect healthy cells with high turnover, causing side effects like myelosuppression. This non-specificity is a key consideration, as it limits dosing and requires monitoring for toxicity.

Choice C reason: Antiviral efficacy does not depend on avoiding re-exposure. Drugs like oseltamivir reduce viral replication during active infection, but re-exposure may cause new infections. Prophylaxis or vaccination prevents reinfection, not the drug’s initial effectiveness, making this statement incorrect for antiviral therapy.

Choice D reason: Antivirals cannot be dosed to eradicate viruses without harming healthy cells. Their mechanisms, like inhibiting viral enzymes, often affect host cells, causing toxicity (e.g., nephrotoxicity with acyclovir). Dose limitations balance efficacy and safety, preventing complete viral eradication without side effects.

Choice A reason: Blurred vision and headaches are not common side effects of niacin. Niacin lowers lipids by inhibiting hepatic VLDL production but primarily causes cutaneous effects like flushing due to prostaglandin release. Neurological symptoms are more associated with other drugs, not niacin’s lipid-lowering mechanism.

Choice B reason: Myalgia and fatigue are not typical niacin side effects. These are more associated with statins, which affect muscle tissue. Niacin’s primary adverse effects involve skin (flushing, pruritus) and gastrointestinal upset, driven by its vasodilatory and metabolic effects, not musculoskeletal symptoms.

Choice C reason: Tinnitus and urine with a burnt odor are not recognized niacin side effects. Niacin causes prostaglandin-mediated flushing and potential hepatotoxicity but does not affect auditory function or urine odor. These symptoms are unrelated to niacin’s mechanism of reducing lipid synthesis.

Choice D reason: Pruritus and cutaneous flushing are common niacin side effects. Niacin triggers prostaglandin release, causing vasodilation, leading to flushing and itching. These effects are dose-dependent and often transient, manageable with aspirin pretreatment or gradual dose escalation, making this the correct adverse effect to monitor.