Drug Interactions > Pharmacology
Exam Review
Types of Drug Interactions
Total Questions : 14
Showing 14 questions, Sign in for moreA nurse is preparing to administer warfarin to a client who also takes aspirin for arthritis pain. What action should the nurse take?
Explanation
Warfarin and aspirin are both anticoagulants that can increase the risk of bleeding. The nurse should hold the warfarin and notify the provider to avoid a potential drug interaction that could cause serious harm to the client.
b. Administering the warfarin as prescribed could result in excessive bleeding or haemorrhage.
c. Reducing the dose of warfarin by half is not appropriate without consulting the provider and monitoring the client's coagulation status.
d. Giving aspirin with food or milk may reduce gastric irritation but does not prevent the drug interaction with warfarin.
A client is prescribed phenytoin for seizure control. The client tells the nurse that they also take St. John's Wort for depression. What should the nurse teach the client?
Explanation
St. John's wort is a herbal supplement that can induce hepatic enzymes and increase the metabolism of phenytoin, reducing its serum levels and therapeutic effects. The nurse should teach the client to avoid taking St. John's wort with phenytoin and to consult the provider before using any herbal products.
a. St. John's wort does not increase the effectiveness of phenytoin but rather decreases it.
c. St. John's wort does not cause drowsiness when taken with phenytoin but rather may increase the risk of seizures due to reduced phenytoin levels.
d. St. John's wort does not cause hypertension when taken with phenytoin but rather may interact with other antihypertensive drugs and affect blood pressure.
A client is receiving gentamicin for a urinary tract infection. The client also takes furosemide for heart failure management. What adverse effect should the nurse monitor for in this client?
Explanation
Gentamicin and furosemide are both ototoxic drugs that can damage the inner ear and cause hearing loss, tinnitus, or vertigo when used together or at high doses. The nurse should monitor for signs of ototoxicity in this client and report any changes in hearing or balance to the provider.
b. Nephrotoxicity is a potential adverse effect of gentamicin and furosemide, but it is not specific to their combination.
c. Cardiotoxicity is not a common adverse effect of gentamicin or furosemide but rather may occur with other drugs that affect cardiac function, such as digoxin or beta-blockers
d. Cardiotoxicity is not a common adverse effect of gentamicin or furosemide but rather may occur with other drugs that affect cardiac function, such as digoxin or beta-blockers
A nurse is preparing to administer medication to a client. The nurse should be aware that which of the following factors can affect the absorption of the medication?
Explanation
The route of administration, the age of the client, and the presence of food in the stomach can all affect the absorption of a medication. For example, oral medications may be absorbed more slowly if taken with food, while intravenous medications are absorbed more quickly because they bypass the digestive system.
a. The route of administration can affect how quickly and completely a medication is absorbed.
b. Age can affect absorption because older adults may have decreased gastric motility and blood flow to the gastrointestinal tract.
c. The presence of food in the stomach can affect absorption by altering gastric pH and delaying gastric emptying. d. All of these factors can affect absorption.
A nurse is reviewing a client’s medication regimen and notes that the client is taking two medications that are both highly protein-bound. The nurse should recognize that this can result in which of the following?
Explanation
When two highly protein-bound medications are taken together, they can compete for binding sites on plasma proteins. This can result in an increased free fraction of one or both medications, leading to an increased risk of adverse effects, decreased effectiveness, and altered distribution.
a. An increased free fraction can result in higher plasma concentrations and an increased risk of adverse effects.
b. Competition for binding sites can decrease the effectiveness of one or both medications by decreasing their plasma concentrations.
c. Altered distribution can occur because changes in protein binding can affect how much medication is distributed to tissues. d. All of these effects can occur when two highly protein-bound medications are taken together.
A client is taking a medication that is metabolized by the liver. The nurse should recognize which of the following factors can affect the metabolism of this medication.
Explanation
The metabolism of a medication can be affected by several factors, including age, liver function, and genetic factors. For example, older adults may have decreased liver function, which can result in a slower metabolism and an increased risk of adverse effects.
a. Age can affect metabolism because liver function decreases with age.
b. Liver function is important for metabolism because many medications are metabolized by liver enzymes.
c. Genetic factors can affect metabolism because some individuals may have genetic variations that affect how they metabolize certain medications.
d. All of these factors can affect metabolism.
A nurse is administering two drugs to a patient and one drug induces the metabolism of another drug’s metabolic pathway. What effect will this have on plasma levels?
Explanation
Induction increases enzyme activity leading to faster metabolism and elimination of drugs resulting in lower plasma levels.
a. plasma levels will occur due to faster elimination of drugs.
b. Increasing plasma levels will not occur as induction increases enzyme activity leading to faster elimination of drugs.
c. No effect will not occur as induction increases enzyme activity leading to faster elimination of drugs.
d. Increasing half-life will not occur as induction increases enzyme activity leading to faster elimination of drugs.
A patient has been prescribed two drugs with opposing pharmacological actions. What effect will this have on their therapeutic effect?
Explanation
Drugs with opposing pharmacological actions will have an antagonistic effect decreasing their therapeutic effect.
a. Increasing therapeutic effect will not occur as drugs with opposing pharmacological actions will have an antagonistic effect decreasing their therapeutic effect.
b. Decreasing therapeutic effect will occur due to an antagonistic effect between drugs with opposing pharmacological actions.
c. No effect will not occur as drugs with opposing pharmacological actions will have an antagonistic effect decreasing their therapeutic effect.
d. Decreasing half-life will not occur as half-life is independent of pharmacological action.
A patient has been prescribed two drugs with one drug inhibiting another drug’s metabolic pathway. What effect will this have on plasma levels?
Explanation
Inhibition decreases enzyme activity leading to slower metabolism and elimination of drugs resulting in higher plasma levels.
a. Decreasing plasma levels will not occur as inhibition decreases enzyme activity leading to slower elimination of drugs.
b. Increasing plasma levels will occur due to slower elimination of drugs.
c. No effect will not occur as inhibition decreases enzyme activity leading to slower elimination of drugs.
d. Increasing half-life will not occur as inhibition decreases enzyme activity leading to slower elimination of drugs.
A patient has been prescribed two drugs with one drug increasing another drug’s excretion. What effect will this have on plasma levels?
Explanation
Increasing excretion leads to faster elimination of drugs resulting in lower plasma levels.
a. Decreasing plasma levels will occur due to faster elimination of drugs.
b. Increasing plasma levels will not occur as increasing excretion leads to faster elimination of drugs.
c. No effect will not occur as increasing excretion leads to faster elimination of drugs.
d. Increasing half life will not occur as increasing excretion leads to faster elimination of drugs.
A nurse is reviewing a client’s medication regimen and notes that the client is taking a medication that is known to be a substrate for CYP450 enzymes. The nurse should recognize that this can result in which of the following?
Explanation
CYP450 enzymes are responsible for metabolizing many medications. If a client is taking a medication that is a substrate for these enzymes, it can result in an increased risk of adverse effects, decreased effectiveness, and altered metabolism.
a. An increased risk of adverse effects can occur because changes in CYP450 enzyme activity can affect how quickly the medication is metabolized and eliminated from the body.
b. Decreased effectiveness can occur because changes in CYP450 enzyme activity can affect how much active drug is available to produce a therapeutic effect.
c. Altered metabolism can occur because changes in CYP450 enzyme activity can affect how the medication is metabolized and eliminated from the body.
d. All of these effects can occur when a client is taking a medication that is a substrate for CYP450 enzymes.
A nurse is preparing to administer a medication to a client who has renal impairment. The nurse should be aware that this can affect which pharmacokinetic process?
Explanation
Renal impairment can affect the excretion of medications because many medications are eliminated by the kidneys.
a. Absorption is not directly affected by renal impairment, although changes in fluid and electrolyte balance can indirectly affect absorption.
b. Distribution is not directly affected by renal impairment, although changes in fluid and electrolyte balance can indirectly affect distribution.
c. Metabolism is not directly affected by renal impairment, although changes in liver function can indirectly affect metabolism.
d. Excretion is directly affected by renal impairment because many medications are eliminated by the kidneys.
A nurse is preparing to administer a medication to a client. The nurse should be aware that which of the following factors can affect the absorption of the medication?
Explanation
The route of administration, the age of the client, and the presence of food in the stomach can all affect the absorption of a medication. For example, oral medications may be absorbed more slowly if taken with food, while intravenous medications are absorbed more quickly because they bypass the digestive system.
a. The route of administration can affect how quickly and completely a medication is absorbed.
b. Age can affect absorption because older adults may have decreased gastric motility and blood flow to the gastrointestinal tract.
c. The presence of food in the stomach can affect absorption by altering gastric pH and delaying gastric emptying.
d. All of these factors can affect absorption.
A nurse is reviewing a client's medication regimen and notes that the client is taking two medications that are both highly protein-bound. The nurse should recognize that this can result in which of the following?
Explanation
When two highly protein-bound medications are taken together, they can compete for binding sites on plasma proteins. This can result in an increased free fraction of one or both medications, leading to an increased risk of adverse effects, decreased effectiveness, and altered distribution.
a. An increased free fraction can result in higher plasma concentrations and an increased risk of adverse effects.
b. Competition for binding sites can decrease the effectiveness of one or both medications by decreasing their plasma concentrations.
c. Altered distribution can occur because changes in protein binding can affect how much medication is distributed to tissues.
d. All of these effects can occur when two highly protein-bound medications are taken together.
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