Which are therapeutic uses of verapamil? (Select all that apply)

Choice A reason: Drugs with toxic side effects, like chemotherapy agents, can affect multiple organs (e.g., liver, kidneys, heart). Monitoring organ function through lab tests (e.g., LFTs, creatinine) detects early toxicity, allowing timely intervention. Patient education on this ensures adherence and awareness, making this the most comprehensive and proactive approach.

Choice B reason: Ordering complete blood counts is relevant for drugs affecting bone marrow (e.g., chemotherapy), but it’s too narrow. Toxic drugs may impact other organs like the liver or kidneys, requiring broader monitoring (e.g., LFTs, renal panels). Focusing solely on blood counts misses other potential toxicities, making this choice incomplete.

Choice C reason: Discontinuing all medications is drastic and inappropriate without assessing the drug’s benefits versus risks. Many toxic drugs (e.g., methotrexate) are essential for treatment. Monitoring and managing side effects are preferred to maintain therapy efficacy while minimizing harm, making this choice clinically unsound.

Choice D reason: Waiting for symptoms before follow-up risks missing subclinical toxicity, as many drug-induced organ damages (e.g., hepatotoxicity) are asymptomatic initially. Proactive monitoring of organ function through lab tests is essential to detect issues early, making this reactive approach inadequate for managing drugs with known toxic effects.

Choice A reason: Bananas do not interact with acetaminophen. They are a potassium-rich food without impact on acetaminophen metabolism or hepatotoxicity. Acetaminophen’s primary risk is liver damage, especially with alcohol or overdose, making bananas irrelevant to its safe use, so this choice is incorrect.

Choice B reason: Leafy green foods, rich in vitamin K, may affect anticoagulants like warfarin but have no significant interaction with acetaminophen. They don’t influence acetaminophen’s metabolism or liver toxicity risk, making this choice irrelevant for patient instructions regarding safe acetaminophen use post-surgery.

Choice C reason: Alcohol increases acetaminophen’s hepatotoxicity by inducing CYP2E1 enzymes, which metabolize acetaminophen into toxic NAPQI, depleting liver glutathione and causing damage. Avoiding alcohol prevents severe liver injury, especially post-surgery when liver function is critical, making this the correct choice for patient safety.

Choice D reason: Dairy products do not interact with acetaminophen’s metabolism or toxicity. They may slow gastric emptying, slightly delaying absorption, but this isn’t a significant concern. Acetaminophen’s primary risk is hepatotoxicity, unaffected by dairy, making this choice incorrect for discharge instructions.