A client who suffers from severe persistent allergic asthma is prescribed omalizumab (Xolair). Which statement below correctly describes the mechanism of action associated with omalizumab (Xolair)?
Inhibits the production of leukotrienes and histamine, preventing further asthma attacks.
Inhibits mast cells from releasing histamine, preventing further asthma attacks
Selectively binds to IgE, reducing allergic mediators and asthma attacks.
Stimulates alpha-adrenergic receptors to assist in reduction of allergic related symptoms.
The Correct Answer is C
A. Inhibits the production of leukotrienes and histamine, preventing further asthma attacks: This statement is misleading. Omalizumab does not directly inhibit the production of leukotrienes or histamine; rather, it works by targeting IgE, which is involved in the allergic response.
B. Inhibits mast cells from releasing histamine, preventing further asthma attacks: While omalizumab does reduce the overall allergic response, it does so by binding to IgE rather than directly inhibiting mast cell activity. Therefore, this description does not accurately represent its primary mechanism of action.
C. Selectively binds to IgE, reducing allergic mediators and asthma attacks: This statement correctly describes the mechanism of action of omalizumab. By binding to immunoglobulin E (IgE), omalizumab prevents IgE from attaching to mast cells and basophils, thus reducing the release of allergic mediators that contribute to asthma attacks.
D. Stimulates alpha-adrenergic receptors to assist in reduction of allergic-related symptoms: This statement is incorrect. Omalizumab does not stimulate alpha-adrenergic receptors; such action is associated with certain bronchodilators. Omalizumab specifically targets IgE to mitigate allergic responses.
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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 C
Explanation
A. CNS Depressants: While there may be general concerns about using multiple medications that affect the central nervous system, CNS depressants do not have a direct interaction with oxymetazoline. Oxymetazoline is primarily a nasal decongestant and its interactions are more specific to other classes of medications.
B. Short Acting Beta Agonist: Short-acting beta agonists (SABAs) are bronchodilators used in asthma management. There is no direct interaction with oxymetazoline; they are used for different purposes and act on different receptors.
C. Monoamine oxidase inhibitors (MAOIs): This option is correct. MAOIs can potentially interact with oxymetazoline, leading to increased blood pressure and other cardiovascular effects. The combination can cause vasoconstriction due to the stimulant effects of both oxymetazoline and the increased levels of norepinephrine resulting from MAOI inhibition.
D. Mast Cell Inhibitors: Mast cell stabilizers do not interact directly with oxymetazoline. These medications are used primarily to manage allergic responses and asthma symptoms and do not have a significant effect on the actions of oxymetazoline.