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
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 D
Explanation
A. Ciprofloxacin is an antibiotic used to treat bacterial infections and is not effective against parasitic infections such as pinworms.
B. Zidovudine is an antiretroviral medication used primarily for HIV treatment and does not target pinworms.
C. Ketoconazole is an antifungal medication that is not indicated for treating pinworm infections.
D. Mebendazole is an anthelmintic medication specifically used to treat pinworm infections by inhibiting the metabolism of the parasite, making it the appropriate choice for this client.