Interactions and contraindications
Interactions and contraindications ( 5 Questions)
A nurse is reviewing the medication history of a client who is prescribed azithromycin for a respiratory infection. The nurse notes that the client is also taking warfarin for atrial fibrillation.
What action should the nurse take?
There is conflicting evidence about the interaction between azithromycin and warfarin. Some studies suggest that azithromycin does not affect warfarin metabolism or prothrombin time, while others report that azithromycin may enhance warfarin’s effects and increase the risk of bleeding or bruising. The FDA approved label revisions for azithromycin warn of a potential interaction with warfarin. Therefore, the nurse should inform the prescriber about this possible interaction and monitor the client’s prothrombin time or International Normalized Ratio (INR) periodically.
Choice B is wrong because it is not enough to instruct the client to monitor for signs of bleeding, such as bruising, hematuria, or melena.
The nurse should also inform the prescriber and check the client’s INR regularly.
Choice C is wrong because it is not advisable to advise the client to increase the intake of vitamin K-rich foods, such as green leafy vegetables, while taking azithromycin.
Vitamin K can reduce the effectiveness of warfarin and increase the risk of clotting. The client should maintain a consistent level of vitamin K intake throughout the treatment with warfarin.
Choice D is wrong because it is not relevant to the question.
Azithromycin does not affect hormonal contraception, such as pills, patches, or rings. The client does not need to use an alternative form of contraception, such as condoms, while taking azithromycin.
There is conflicting evidence about the interaction between azithromycin and warfarin. Some studies suggest that azithromycin does not affect warfarin metabolism or prothrombin time, while others report that azithromycin may enhance warfarin’s effects and increase the risk of bleeding or bruising. The FDA approved label revisions for azithromycin warn of a potential interaction with warfarin. Therefore, the nurse should inform the prescriber about this possible interaction and monitor the client’s prothrombin time or International Normalized Ratio (INR) periodically.
Choice B is wrong because it is not enough to instruct the client to monitor for signs of bleeding, such as bruising, hematuria, or melena.
The nurse should also inform the prescriber and check the client’s INR regularly.
Choice C is wrong because it is not advisable to advise the client to increase the intake of vitamin K-rich foods, such as green leafy vegetables, while taking azithromycin.
Vitamin K can reduce the effectiveness of warfarin and increase the risk of clotting. The client should maintain a consistent level of vitamin K intake throughout the treatment with warfarin.
Choice D is wrong because it is not relevant to the question.
Azithromycin does not affect hormonal contraception, such as pills, patches, or rings. The client does not need to use an alternative form of contraception, such as condoms, while taking azithromycin.