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 B
Explanation
A. Hypertension: Fluticasone, a corticosteroid, is not typically associated with causing hypertension directly. However, chronic use can lead to fluid retention and hypertension in some individuals, but it is not a primary concern compared to other side effects.
B. Fungal infections: This is a significant adverse effect associated with inhaled corticosteroids like fluticasone. Prolonged use can increase the risk of oral thrush and other fungal infections due to the immunosuppressive effects of corticosteroids. Monitoring for signs of infection is crucial.
C. Decreased immunity: While long-term use of systemic corticosteroids can lead to decreased immune function, inhaled fluticasone is less likely to cause significant immunosuppression. However, it can still impact local immunity in the airways, making monitoring for infections more relevant than generalized immune suppression.
D. Hypoglycemia: Fluticasone is not known to cause hypoglycemia. In fact, corticosteroids typically can lead to increased blood glucose levels rather than lowering them, especially with chronic use, making this option inaccurate in the context of monitoring for adverse effects.
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.