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 B
Explanation
A. Stimulates effects of histamine by occupying all H receptor sites: This statement inaccurately describes the action of diphenhydramine. Instead of stimulating histamine effects, diphenhydramine actually blocks them, particularly at H1 receptors, which areinvolved in allergic responses.
B. Blocks effects of histamine by competing and occupying H1 receptor sites: This accurately describes the mechanism of action of diphenhydramine. As an antihistamine, it competes with histamine for binding to H1 receptor sites, effectively reducing symptoms of allergies, such as sneezing, itching, and nasal congestion.
C. Blocks effects of histamine by competing and occupying H2 receptor sites: This option is incorrect because H2 receptor antagonists are used primarily to reduce gastric acid secretion, not to treat allergic reactions. Diphenhydramine specifically targets H1 receptors, not H2 receptors.
D. Stimulates effects of histamine by increasing the amount of H2 receptor sites: This statement is also incorrect. Diphenhydramine does not stimulate histamine activity or increase receptor sites. Instead, it functions to inhibit the action of histamine at H1 receptors, which is fundamental in alleviating allergy symptoms.
Correct Answer is A
Explanation
A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.