A client presents to the healthcare setting with a diagnosis of emphysema. Which of the following medications below would be contraindicated with the client's allergy to soybeans?
montelukast (Singulair)
methylprednisolone (Solumedrol)
ipratropium bromide (Atrovent)
albuterol (Ventolin)
The Correct Answer is C
A) Montelukast (Singulair): This medication is a leukotriene receptor antagonist used to manage asthma and allergic rhinitis. It does not contain soy or soy-derived ingredients, making it a safe option for a client with a soybean allergy. There are no known contraindications related to soy in this medication.
B) Methylprednisolone (Solumedrol): This is a corticosteroid used to reduce inflammation. It is not contraindicated for clients with a soybean allergy, as it does not contain soy-derived components. The medication primarily poses risks related to long-term use, but not specifically regarding soybean allergies.
C) Ipratropium bromide (Atrovent): This medication is an anticholinergic used to relieve bronchospasm. Ipratropium bromide is formulated with soy lecithin, which is derived from soybeans. Therefore, it is contraindicated for clients with a known allergy to soybeans, as it may trigger an allergic reaction.
D) Albuterol (Ventolin): This medication is a short-acting beta-agonist used for quick relief of bronchospasm. It does not contain any soy components and is generally safe for patients with soybean allergies. While there may be other considerations for its use, the allergy to soy is not a concern with this medication.
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Correct Answer is ["C","E"]
Explanation
A. This medication (Benadryl) targets H2 receptors to alleviate symptoms: This statement is incorrect. Diphenhydramine is an H1 receptor antagonist, not an H2 antagonist. H1 receptors are primarily involved in allergic reactions, whereas H2 receptors are related to gastric acid secretion.
B. Take this medication on an empty stomach before breakfast. Drowsiness is a common side effect of diphenhydramine (Benadryl): While drowsiness is indeed a common side effect, taking diphenhydramine on an empty stomach is not necessarily required and may lead to gastrointestinal discomfort. It can be taken with food if preferred.
C. Avoid CNS depressants while taking diphenhydramine (Benadryl): This is an important teaching point. Diphenhydramine can cause sedation, and the use of other CNS depressants (like alcohol or sedatives) can enhance this effect, increasing the risk of excessive drowsiness or other complications.
D. This medication is a 2nd generation antihistamine: This statement is incorrect. Diphenhydramine is actually a first-generation antihistamine. First-generation antihistamines tend to cause more sedation and other side effects compared to second-generation antihistamines, which are less sedating.
E. Paradoxical reactions can be seen with this medication: This is true. In some individuals, particularly children, diphenhydramine can cause paradoxical reactions, such as increased excitability or hyperactivity, rather than the expected sedation. This is an important consideration to discuss with clients.
Correct Answer is D
Explanation
A. Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa: This describes the action of decongestants, not guaifenesin. Guaifenesin does not work by constricting blood vessels; rather, its primary function is to help manage mucus production.
B. Compete with histamine for receptor sites, thus preventing a histamine response and overall congestion: This mechanism is associated with antihistamines, which are used to relieve symptoms of allergic reactions, not with guaifenesin. Guaifenesin does not block histamine but focuses on mucus management.
C. Treat allergic rhinitis and prevent motion sickness: While these are common uses for antihistamines, they do not apply to guaifenesin. Guaifenesin is primarily an expectorant and is not indicated for treating allergic rhinitis or motion sickness.
D. Loosen bronchial secretion to assist in elimination: Guaifenesin acts as an expectorant, promoting the clearance of mucus from the airways by loosening bronchial secretions. This facilitates easier expectoration of mucus, helping to relieve chest congestion associated with upper respiratory infections.