The nurse is assessing the medication record of a newly admitted client. Which of the following medications directly interacts with oxymetazoline (Afrin)?
CNS Depressants
Short acting Beta Agonist
Monoamine oxidase inhibits
Mast Cell inhibitors
The Correct Answer is C
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.
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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 ["A","C"]
Explanation
A) Decongestants: These medications are primarily used to relieve nasal congestion associated with upper respiratory conditions such as allergic rhinitis and the common cold. They work by constricting blood vessels in the nasal passages, thereby reducing swelling and congestion. Common examples include pseudoephedrine and phenylephrine.
B) H2 Antagonist: H2 antagonists are primarily used to reduce gastric acid secretion and treat conditions such as peptic ulcers and gastroesophageal reflux disease (GERD). They are not indicated for upper respiratory conditions, so this option does not apply.
C) H1 Antagonist: H1 antagonists, or antihistamines, are used to alleviate symptoms of allergies, hay fever, and other upper respiratory conditions by blocking the effects of histamine. This class includes both first-generation antihistamines (like diphenhydramine) and second-generation antihistamines (like cetirizine), making them relevant for upper respiratory issues.
D) Long-Acting Beta Agonist (LABA): LABAs are primarily used for the management of asthma and chronic obstructive pulmonary disease (COPD), targeting the lower respiratory tract. They are not typically used for upper respiratory conditions, so this option does not apply.
E) Short Acting Beta Agonist (SABA): SABAs, such as albuterol, are primarily used for acute asthma attacks and bronchospasm in conditions like COPD. They act on the lower respiratory tract and are not indicated for upper respiratory conditions.
F) Mast Cell Stabilizers: These medications are used to prevent allergic reactions and asthma symptoms by stabilizing mast cells and preventing the release of histamine and other inflammatory mediators. While they may have a role in allergic rhinitis, they are not the primary treatment for upper respiratory tract conditions, making this option less applicable compared to decongestants and H1 antagonists.