The nurse is preparing to administer albuterol to a client experiencing an acute asthma attack. Which medication on the client's medical record is a direct contraindication to albuterol administration?
Beta-Blockers
Anticholinergics
Antihistamines
Glucocorticoids
The Correct Answer is A
A) Beta-Blockers: The use of beta-blockers is a direct contraindication to albuterol administration. Albuterol is a beta-agonist that works by stimulating beta-2 adrenergic receptors to cause bronchodilation. Beta-blockers can antagonize this effect, potentially leading to increased bronchospasm and worsening asthma symptoms. Therefore, if a client is on beta-blockers, caution must be exercised when administering albuterol.
B) Anticholinergics: Anticholinergics, such as ipratropium, are often used in conjunction with beta-agonists like albuterol to provide synergistic effects in managing asthma. There are no direct contraindications between anticholinergics and albuterol, and they can be used together safely to improve bronchial dilation and mucus clearance.
C) Antihistamines: Antihistamines are not contraindicated with albuterol. While they may be used for managing allergic reactions and symptoms, they do not interfere with the action of beta-agonists. Therefore, a client taking antihistamines can still safely receive albuterol for acute asthma attacks.
D) Glucocorticoids: Glucocorticoids, such as prednisone, are often used in asthma management for their anti-inflammatory properties. They are not contraindicated with albuterol; in fact, they are commonly used together in asthma treatment plans. Glucocorticoids help to reduce airway inflammation, while albuterol provides quick relief from bronchospasm.
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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 A
Explanation
A. This medication is for long-term treatment for asthma: This statement indicates an accurate understanding of montelukast. It is a leukotriene receptor antagonist used for long-term control and management of asthma symptoms and to prevent exercise-induced bronchoconstriction.
B. This medication has a tendency to produce anaphylaxis: This statement is incorrect. While allergic reactions can occur with montelukast, it is not commonly associated with anaphylaxis. Clients should be aware of potential side effects, but anaphylaxis is not a common risk.
C. I can repeat this medication twice prior to seeking medical attention: This statement is misleading. Montelukast is taken once daily for asthma management, and it is not meant to be repeated or used as a rescue medication in acute situations. Clients should seek medical attention for worsening symptoms instead of relying on repeating doses.
D. Bloodwork is required regularly to monitor the therapeutic levels of this medication: This statement is incorrect. Montelukast does not require routine blood monitoring for therapeutic levels, unlike some other medications used for asthma management. It is generally well-tolerated without the need for regular blood tests.