The nurse is caring for a client who has begun to take sertraline (Zoloft) for newly diagnosed depression. Which of the following conditions is associated with an overdose of this medication class?
Tardive Dyskinesia
Serotonin syndrome
Hypertensive Emergency
Extrapyramidal Syndrome
The Correct Answer is B
A. Tardive dyskinesia is primarily associated with long-term use of antipsychotics, not SSRIs like sertraline.
B. Serotonin syndrome is a serious condition that can occur with overdose or interaction of SSRIs, leading to symptoms such as agitation, confusion, rapid heart rate, and increased muscle tone.
C. Hypertensive emergency is not typically associated with SSRIs; it is more related to the use of MAOIs and certain foods.
D. Extrapyramidal syndrome is also primarily linked to antipsychotics rather than SSRIs and would not be a concern with sertraline use.
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Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.
Correct Answer is B
Explanation
A. Carvedilol is a beta-blocker that is often used in hypertension management but is not considered a first-line treatment.
B. Lisinopril, an ACE inhibitor, is a first-line treatment for hypertension due to its effectiveness and safety profile, making it a common choice for initial therapy.
C. Doxazosin is an alpha-1 blocker that can be used for hypertension but is not typically a first-line treatment due to the risk of side effects like hypotension.
D. Clonidine is a central alpha agonist used in certain situations for hypertension but is not considered a first-line therapy due to potential adverse effects and sedation.