A nurse is teaching a client with a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use when experiencing an acute asthma attack?
Ipratropium bromide
Albuterol
Salmeterol
Budesonide
The Correct Answer is B
A) Ipratropium bromide: While ipratropium is used to manage bronchospasm, it is typically not the first choice for acute asthma attacks. It has a slower onset of action compared to short-acting beta-agonists like albuterol and is generally used as an adjunct therapy rather than for immediate relief.
B) Albuterol: This medication is a short-acting beta-agonist that provides rapid relief of bronchospasm during an acute asthma attack. It works by relaxing the muscles in the airways, making it the preferred first-line treatment for quick relief in asthma exacerbations.
C) Salmeterol: This medication is a long-acting beta-agonist (LABA) used for long-term control of asthma symptoms, not for immediate relief. It has a delayed onset of action and should not be used as a rescue medication during an acute attack, as it may take longer to provide effects.
D) Budesonide: This is an inhaled corticosteroid that helps in controlling chronic inflammation associated with asthma. While important for long-term management, it is not effective for the rapid relief of acute symptoms and should not be used during an asthma attack.
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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.
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.