Which medications are most likely to be used in a dual drug therapy program for peptic ulcer disease from H. pylori?
Omeprazole and clarithromycin
Ciprofloxacin and sucralfate
Cimetidine and amoxicillin
Tetracycline and metronidazole
The Correct Answer is A
A) Omeprazole and clarithromycin: Omeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production, and clarithromycin is an antibiotic used to target Helicobacter pylori (H. pylori), the bacteria responsible for many peptic ulcers. In dual therapy for H. pylori eradication, omeprazole is used to create a less acidic environment, enhancing the effectiveness of antibiotics like clarithromycin. This combination is one of the most commonly used regimens in the treatment of peptic ulcer disease caused by H. pylori.
B) Ciprofloxacin and sucralfate: Ciprofloxacin is an antibiotic, and sucralfate is a medication used to coat the stomach lining to protect it from acid. While ciprofloxacin may be effective against certain bacterial infections, it is not typically used in dual therapy for H. pylori infections. Sucralfate is not an antibiotic and does not directly treat the bacterial cause of peptic ulcers, so this combination would not be ideal for H. pylori eradication.
C) Cimetidine and amoxicillin: Cimetidine is an H2-receptor antagonist used to reduce stomach acid production, and amoxicillin is an antibiotic that could potentially target H. pylori. However, this combination is less commonly used compared to PPI-based therapies. Cimetidine does not reduce acid as effectively as omeprazole (a PPI), making this combination less ideal for eradicating H. pylori.
D) Tetracycline and metronidazole: Both tetracycline and metronidazole are antibiotics used to treat infections, including H. pylori, but they are typically used in triple therapy regimens along with a PPI, not in dual therapy. While they can be effective in treating H. pylori, the combination of a PPI like omeprazole with clarithromycin remains the preferred choice for dual therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["20"]
Explanation
1. Determine the concentration of the guaifenesin:
The label states 100 mg/5 mL.
2. Set up a proportion to find the volume (in mL) needed:
100 mg / 5 mL = 400 mg / x mL
3. Solve for x:
Cross-multiply: 100x = 400 * 5
100x = 2000
x = 2000 / 100
x = 20 mL
Answer: The nurse will administer 20 mL to the client.
Correct Answer is B
Explanation
A) The drugs will compete for receptor sites: While it's true that highly protein-bound drugs can compete for binding sites on proteins (like albumin), the main issue with highly protein-bound drugs interacting is not related to competition for receptor sites. The primary concern is how the drugs displace each other from the protein-binding sites, which can increase the free (active) drug levels in the bloodstream. This can lead to a higher pharmacological effect, especially if the unbound drug concentration rises to a therapeutic or toxic level.
B) The client will have increased effects of both drugs: This is the correct answer. When two highly protein-bound drugs are administered together, they can displace each other from protein-binding sites. This displacement increases the amount of free (active) drug in circulation, which may intensify the pharmacologic effects of both drugs. For example, if one drug displaces the other from its protein-binding site, more of the free drug will be available to exert its effects. This can increase the risk of side effects, toxicity, or both.
C) The client will have decreased effects of both drugs: This is incorrect. The opposite is true—when two highly protein-bound drugs are given together, the displacement of one drug increases the amount of the free drug available, leading to a stronger effect, not a weaker one. Decreased effects would occur if the drug had no access to the target receptor or if it were metabolized or eliminated too quickly, which isn't the case in this scenario.
D) Both drugs are equally bound to protein: While both drugs may bind to protein, they do not necessarily bind equally. One drug might bind more strongly or more selectively to the protein than the other, which could lead to displacement of the weaker-bound drug. The important point is that their competition for protein-binding sites can lead to an increase in free (active) drug concentrations.
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