The nurse is caring for a client with swelling to the distal phalanges, first big toe, and 10/10 pain. Which medication below would be administered for this client's acute gout?
allopurinol
febuxostat
colchicine
physostigmine
The Correct Answer is C
A. Allopurinol is a xanthine oxidase inhibitor used for chronic gout management and prevention, not for acute attacks.
B. Febuxostat is also used for chronic management of gout and not effective for immediate relief of an acute attack.
C. Colchicine is indicated for the treatment of acute gout flares as it helps reduce inflammation and pain associated with gout attacks.
D. Physostigmine is an antidote for anticholinergic toxicity and has no role in treating gout.
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Correct Answer is ["B","C","F"]
Explanation
A. Morphine administered intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect entirely.
B. Diphenhydramine in tablet form is absorbed through the gastrointestinal tract and undergoes significant first-pass metabolism in the liver, affecting its bioavailability.
C. Famotidine in tablet form is also subject to first-pass metabolism, which can reduce its effectiveness.
D. Nitroglycerin sublingual tablets are designed to bypass the first-pass metabolism by being absorbed directly into the bloodstream through the mucous membranes.
E. The same applies to nitroglycerin 10mg sublingual tablets; they also avoid the first-pass effect due to sublingual administration.
F. Acetaminophen is taken orally and undergoes first-pass metabolism in the liver, which can significantly affect its overall bioavailability.
Correct Answer is C
Explanation
A. LABAs can help prevent asthma attacks, including those triggered by exercise, so this statement is accurate and does not indicate a need for further education.
B. LABAs may cause side effects like an increased heart rate, which the client correctly recognizes.
C. LABAs are not intended for immediate relief of asthma symptoms; they are for long-term control. A short-acting beta2-agonist (SABA) should be used for acute symptoms, indicating this client needs further education.
D. Over time, tolerance can develop with some medications, and this understanding is accurate, so it does not indicate a need for additional teaching.