Which of the following best describes how grapefruit juice typically interacts with medications?
It increases the metabolism of drugs in the liver
It decreases the absorption of medications
It only affects medications taken in the morning
It blocks the action of enzymes, leading to increased drug levels in the blood
The Correct Answer is D
A. It increases the metabolism of drugs in the liver: Grapefruit juice actually inhibits, rather than increases, the activity of liver enzymes particularly CYP3A4 resulting in slower drug metabolism and higher plasma concentrations of certain medications.
B. It decreases the absorption of medications: Grapefruit juice does not generally reduce drug absorption. In fact, by inhibiting intestinal enzymes, it can increase the absorption and bioavailability of some drugs, potentially raising them to toxic levels.
C. It only affects medications taken in the morning: The interaction is not time-specific. Grapefruit juice can affect drug metabolism even when consumed hours apart from the medication, as enzyme inhibition can persist for up to 24–72 hours.
D. It blocks the action of enzymes, leading to increased drug levels in the blood: Grapefruit juice inhibits cytochrome P450 enzymes especially CYP3A4 in the intestinal wall. This results in decreased drug breakdown and higher systemic concentrations, increasing the risk of adverse effects and toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A. Beta-blockers like metoprolol can mask the signs of hypoglycemia: Metoprolol can blunt adrenergic symptoms such as tachycardia and tremors, which are key warning signs of hypoglycemia. This is especially concerning in diabetic patients who rely on these symptoms for early detection of low blood glucose.
B. It is safe to take additional doses of Sertraline if the patient feels like their symptoms are worsening: Sertraline, a selective serotonin reuptake inhibitor (SSRI), must be taken exactly as prescribed. Taking extra doses increases the risk of serotonin syndrome, which can be life-threatening and requires medical supervision for dosage adjustments.
C. The patient should be monitored for orthostatic hypotension: Older adults taking medications like metoprolol and triazolam are at increased risk for orthostatic hypotension due to vasodilation and CNS depression. Monitoring helps prevent falls and syncope, especially when changing positions.
D. Oxycodone can be used long-term without risk of physical dependence: Oxycodone is an opioid analgesic and carries a high risk of tolerance, physical dependence, and addiction when used long-term. Even when used appropriately, patients can develop dependence, necessitating careful monitoring.
E. The combination of triazolam and oxycodone increases the risk of respiratory depression: Both drugs are CNS depressants, and their combination can have a synergistic effect on respiratory centers in the brain. This raises the risk of severe respiratory depression, particularly in older adults or those with underlying respiratory conditions.
Correct Answer is B
Explanation
A. Apply the drops directly onto the patient's cornea: Eye drops should be instilled into the conjunctival sac, not directly onto the cornea. The cornea is highly sensitive, and direct application can cause discomfort, injury, and decreased patient adherence.
B. Perform punctal occlusion after instilling the drops: Punctal occlusion (gentle pressure on the inner corner of the eye) for 1–2 minutes reduces systemic absorption of the drug via the nasolacrimal duct. This is especially important with beta-blockers like Timolol, which can cause systemic effects such as bradycardia and hypotension.
C. Administer the medication immediately after meals: The timing of Timolol eye drops is not dependent on meals. Food intake has no impact on the efficacy or absorption of ophthalmic medications.
D. Instruct the patient to blink rapidly after instillation: Blinking rapidly can cause the medication to be expelled from the eye, reducing its effectiveness. Patients should be instructed to gently close the eye for a minute or two to enhance absorption.
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