The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant.
Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?

Choice A rationale:

Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.

However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.

Choice B rationale:

Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.

Choice C rationale:

The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.

Choice D rationale:

Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.

Choice A rationale:

Sodium levels in the blood are typically between 135 and 145 milliequivalents per liter (mEq/L). A sodium level of 140 mEq/L falls within this range, indicating normal sodium levels. Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance. A normal sodium level is therefore crucial for the body’s overall function.

Choice B rationale:

A glucose level of 120 mg/dL is considered normal for a fasting blood sugar test. Glucose is your body’s main source of energy. It comes from the food you eat and is carried through your bloodstream to the cells of your body. If the glucose level in the blood is too high or too low, it can indicate a medical condition such as diabetes.

Choice C rationale:

Potassium levels in the blood are typically between 3.6 and 5.2 millimoles per liter (mmol/L). A potassium level of 4.5 mEq/L falls within this range, indicating normal potassium levels. Potassium is a type of electrolyte that is vital to the function of nerve and muscle cells, including those in your heart. Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L). Having a blood potassium level higher than 6.0 mmol/L can be dangerous and usually requires immediate treatment.

Choice D rationale:

The Blood Urea Nitrogen (BUN) test is a routine test used to assess kidney function. Urea nitrogen is a waste product that’s created in your liver when the body breaks down proteins. Healthy kidneys filter urea nitrogen from your blood, but when your kidneys aren’t working well, the BUN level rises. The normal range for BUN is typically around 7-20 mg/dL2. A BUN level of 55 mg/dL is significantly higher than the normal range, indicating that the kidneys may not be functioning properly. This is a critical finding that should be reported to the provider before initiating the medication amphotericin B. Amphotericin B is an antifungal medication used to treat serious, life-threatening fungal infections. However, it is known for its severe and potentially lethal side effects, including kidney damage. Therefore, a high BUN level should be reported to the provider before initiating this medication.