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Acetaminophen
Acetaminophen ( 5 Questions)
A nurse is reviewing the medication history of a client who has a prescription for acetaminophen.
Which of the following medications should the nurse identify as increasing the risk of hepatotoxicity when taken with acetaminophen?
Warfarin is an anticoagulant drug that does not affect the metabolism of acetaminophen. However, acetaminophen can increase the anticoagulant effect of warfarin by inhibiting its metabolism, which can increase the risk of bleeding.
Carbamazepine is an anticonvulsant drug that can induce the activity of cytochrome P450 enzymes in the liver. These enzymes are responsible for metabolizing acetaminophen into a toxic intermediate called N-acetyl-p-benzoquinone imine (NAPQI), which can cause liver injury by depleting glutathione and covalently binding to cellular proteins. Therefore, taking carbamazepine with acetaminophen can increase the risk of hepatotoxicity by enhancing the formation of NAPQI.
Furosemide is a diuretic drug that does not interact with acetaminophen. However, furosemide can cause dehydration and electrolyte imbalance, which can affect liver function and increase the susceptibility to acetaminophen-induced liver injury.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not affect the metabolism of acetaminophen. However, ibuprofen can cause gastrointestinal irritation and renal impairment, which can also increase the risk of acetaminophen-induced liver injury. Additionally, taking both acetaminophen and ibuprofen can increase the risk of overdose and toxicity.
Carbamazepine is an anticonvulsant drug that can induce the activity of cytochrome P450 enzymes in the liver. These enzymes are responsible for metabolizing acetaminophen into a toxic intermediate called N-acetyl-p-benzoquinone imine (NAPQI), which can cause liver injury by depleting glutathione and covalently binding to cellular proteins. Therefore, taking carbamazepine with acetaminophen can increase the risk of hepatotoxicity by enhancing the formation of NAPQI.
Choice A is wrong because warfarin is an anticoagulant drug that does not affect the metabolism of acetaminophen. However, acetaminophen can increase the anticoagulant effect of warfarin by inhibiting its metabolism, which can increase the risk of bleeding.
Choice C is wrong because furosemide is a diuretic drug that does not interact with acetaminophen. However, furosemide can cause dehydration and electrolyte imbalance, which can affect liver function and increase the susceptibility to acetaminophen-induced liver injury.
Choice D is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not affect the metabolism of acetaminophen. However, ibuprofen can cause gastrointestinal irritation and renal impairment, which can also increase the risk of acetaminophen-induced liver injury. Additionally, taking both acetaminophen and ibuprofen can increase the risk of overdose and toxicity.