A client with a leukemia has been placed on methotrexate. Which of the following mechanism of actions below describes this medication?
Stops fungal growth
Alters pH level
Inhibits replication by blocking folic acid synthesis
Inhibits helper T Cells
The Correct Answer is C
A. Stops fungal growth: Methotrexate is not an antifungal medication. This mechanism of action applies to drugs like azoles or polyenes, which are used to treat fungal infections.
B. Alters pH level: Altering pH is a mechanism used by some antacids or alkalinizing agents, not methotrexate.
C. Inhibits replication by blocking folic acid synthesis: Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, an enzyme involved in folic acid synthesis. This inhibition impairs DNA synthesis, which is crucial in treating leukemia and other cancers.
D. Inhibits helper T cells: This mechanism of action is more closely related to immunosuppressive agents like cyclosporine or tacrolimus, which are used for preventing transplant rejection.
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Correct Answer is D
Explanation
A. Macrolides: Macrolides, such as azithromycin or erythromycin, are often used as alternatives in clients with a penicillin allergy, as they do not have a beta-lactam ring and generally do not cause cross-reactivity.
B. Antiretrovirals: Antiretrovirals are used for treating HIV/AIDS and are unrelated to penicillin antibiotics, with no cross-sensitivity concerns.
C. Antimalarials: Antimalarial drugs are used to treat malaria and are not related to penicillin antibiotics, so they would not be a concern for cross-sensitivity.
D. Cephalosporins: Cephalosporins have a beta-lactam structure similar to penicillins, which can sometimes cause cross-reactivity in clients with a penicillin allergy. However, the risk is lower with newer generations.
Correct Answer is A
Explanation
A. Lactic acidosis: Zidovudine has a black box warning for lactic acidosis, a rare but serious complication that can be life-threatening. The nurse should educate the client about symptoms of lactic acidosis, such as muscle pain and weakness.
B. Uterine Cancer: Zidovudine is not associated with uterine cancer.
C. Oral Candidiasis: This is not a black box warning for zidovudine, though oral candidiasis can occur in immunocompromised clients.
D. Thromboembolic Events: This is not a known black box warning for zidovudine.