The nurse is caring for a client currently taking oxymetazoline. Which of the following statements should the nurse include regarding oxymetazoline?
Limit use of the drug to 3 days to prevent rebound nasal congestion
This drug may be used in maintenance treatment for asthma
This medication may take up to a week to see effects
Take this drug at bedtime because it may cause drowsiness
The Correct Answer is A
A. Limit use of the drug to 3 days to prevent rebound nasal congestion: Oxymetazoline is a topical nasal decongestant that can lead to rebound congestion if used for more than three consecutive days. This condition, known as rhinitis medicamentosa, can worsen nasal congestion rather than alleviate it, making it crucial for clients to adhere to this guideline.
B. This drug may be used in maintenance treatment for asthma: Oxymetazoline is not indicated for the maintenance treatment of asthma. It is a nasal decongestant, primarily used for temporary relief of nasal congestion due to colds or allergies, and does not address the underlying inflammation in asthma.
C. This medication may take up to a week to see effects: In fact, oxymetazoline provides rapid relief of nasal congestion, typically within minutes of administration. Clients should expect to feel its effects much sooner rather than having to wait a week, which can lead to misuse or overuse of the medication.
D. Take this drug at bedtime because it may cause drowsiness: Oxymetazoline is not known to cause drowsiness; rather, it works as a decongestant. Patients are usually advised to use it during the day as needed, and it should not be specifically recommended for bedtime use
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Correct Answer is A
Explanation
A) Cetirizine (Zyrtec): This medication is classified as a second-generation antihistamine. Second-generation antihistamines are designed to be less sedating than first-generation agents, as they are less likely to cross the blood-brain barrier. Cetirizine effectively alleviates symptoms of allergic rhinitis by blocking histamine receptors and is commonly used due to its efficacy and reduced sedation compared to older antihistamines.
B) Chlorpheniramine (Aller-Chlor): Chlorpheniramine is a first-generation antihistamine. It tends to cause more sedation and has a higher likelihood of causing side effects such as drowsiness, dry mouth, and dizziness. First-generation antihistamines are typically less selective and can affect the central nervous system more significantly than their second-generation counterparts.
C) Diphenhydramine (Benadryl): This medication is also a first-generation antihistamine. It is well-known for its sedative effects and is often used for allergic reactions, as well as for its sleep-inducing properties. Like other first-generation antihistamines, diphenhydramine can cause significant drowsiness and other anticholinergic effects.
D) Montelukast (Singulair): Montelukast is not an antihistamine but rather a leukotriene receptor antagonist. It is used for the management of allergic rhinitis and asthma but works through a different mechanism by blocking leukotriene receptors, thereby reducing inflammation and mucus production. It is not classified as an antihistamine, either first or second generation.
Correct Answer is ["B","D","E","F"]
Explanation
A) Ipratropium is the drug of choice for acute asthma exacerbations: This statement is incorrect. While ipratropium is used in the management of asthma, it is not the first-line treatment for acute exacerbations. Short-acting beta-agonists, such as albuterol, are the preferred choice for rapid relief during an acute asthma attack due to their quick onset of action.
B) Mechanism of action includes blocking acetylcholine receptors in the airway: This statement is accurate. Ipratropium is an anticholinergic agent that works by blocking acetylcholine receptors in the bronchial smooth muscle. This action leads to bronchodilation and helps to decrease mucus production, making it effective for managing airway constriction.
C) Mechanism of action includes antagonizing histamine receptors of the upper airway: This statement is incorrect. Ipratropium does not act on histamine receptors; rather, it specifically targets acetylcholine receptors. Antihistamines are the medications that block histamine receptors, primarily used for allergic reactions and rhinitis, but not for bronchodilation in asthma.
D) Client's who are allergic to soybean should avoid taking ipratropium: This statement is true. Ipratropium bromide may contain soy lecithin, which can pose a risk for patients with soybean allergies. Therefore, it is essential for healthcare providers to assess a patient’s allergy history before prescribing this medication.
E) Urinary retention is a side effect of Ipratropium bromide: This is correct. Anticholinergic medications, including ipratropium, can lead to urinary retention as a side effect due to their action of inhibiting acetylcholine, which plays a role in bladder function. Patients should be monitored for this side effect, especially if they have a history of urinary issues.
F) Ipratropium (Atrovent) is a medication for asthma and chronic obstructive pulmonary disease (COPD): This statement is accurate. Ipratropium is indicated for both asthma and COPD management, as it helps to relieve bronchospasm and improve airflow. It is often used as an adjunct therapy in combination with other bronchodilators for better management of respiratory conditions.