A nurse is caring for a client who is currently 34-weeks gestation. Which of the following medications would be avoided due to its category X classification?
morphine
famotidine (Pepcid)
misoprostol (Cytotec)
ibuprofen (Advil)
The Correct Answer is C
A. Morphine is a category C medication, which means it may be used if the benefits outweigh the risks; it is not contraindicated in pregnancy.
B. Famotidine (Pepcid) is also a category B medication and is generally considered safe to use during pregnancy.
C. Misoprostol (Cytotec) is classified as category X due to its association with causing uterine contractions and the potential for fetal harm; thus, it should be avoided during pregnancy.
D. Ibuprofen (Advil) is a category C medication, and while it is not typically recommended in the third trimester, it is not classified as category X.
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Correct Answer is D
Explanation
A. Hydralazine is a vasodilator that does not directly replace ACE inhibitors and is not the preferred alternative for managing hypertension or heart failure.
B. Metoprolol is a beta-blocker that is used for different indications and is not a direct substitute for ACE inhibitors.
C. Furosemide is a loop diuretic used for fluid management, not as an alternative to ACE inhibitors.
D. Losartan is an angiotensin II receptor blocker (ARB) and serves as a suitable alternative to ACE inhibitors for patients who experience a cough from them, as ARBs do not typically cause this side effect.
Correct Answer is C
Explanation
A. Macrolides, such as azithromycin and erythromycin, have a low cross-reactivity with penicillin and are typically safe alternatives for those with penicillin allergies.
B. Sulfonamides are not structurally similar to penicillins and generally do not have cross-sensitivity issues with penicillin allergies.
C. Cephalosporins share a similar beta-lactam structure to penicillins, which can result in cross-sensitivity in some individuals with a penicillin allergy. For this reason, they should be avoided or used with caution in these clients.
D. Tetracyclines have a different structure from penicillins and are usually safe for clients with penicillin allergies.