The nurse is caring for an immunosuppressed pediatric client who reports soreness in his mouth and refuses to eat. Inspection of his mouth reveals a white, milky plaque that does not come off with rubbing. The nurse should anticipate which drug to be administered to this client?
nystatin (Mycostatin)
amoxicillin (Amoxil)
metronidazole (Flagyl)
acyclovir (Zovirax)
The Correct Answer is A
A. Nystatin is an antifungal medication used to treat oral candidiasis (thrush), which is consistent with the client's symptoms of soreness in the mouth and the presence of a white, milky plaque that does not rub off.
B. Amoxicillin is an antibiotic that treats bacterial infections but would not be effective against fungal infections like oral thrush.
C. Metronidazole is an antibiotic and antiprotozoal medication, which is not appropriate for treating oral candidiasis.
D. Acyclovir is an antiviral medication used to treat infections caused by certain viruses, such as herpes, and is not effective for fungal infections like thrush.
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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 ["A","B","E"]
Explanation
A. Decongestants are commonly used to relieve nasal congestion in upper respiratory tract infections by constricting blood vessels in the nasal passages.
B. Expectorants help thin mucus and are used in upper respiratory conditions to facilitate coughing up mucus.
C. H2 antagonists are primarily used to reduce stomach acid and are not indicated for upper respiratory conditions.
D. Short-acting beta agonists (SABAs) are primarily used in the management of lower respiratory tract conditions, such as asthma and COPD, rather than upper respiratory conditions.
E. H1 antagonists (antihistamines) are effective for treating allergic reactions and symptoms of upper respiratory infections, such as runny nose and sneezing.
F. Long-acting beta agonists (LABAs) are also used primarily for lower respiratory tract conditions and are not appropriate for treating upper respiratory issues.