The nurse is reviewing a client's daily medications taken at home. Which of the following medications has a risk of dependency if used daily?
bisacodyl (Dulcolax)
psyllium (Metamucil)
polyethylene glycol (MiraLAX)
docusate sodium (Colace)
The Correct Answer is A
A. Bisacodyl is a stimulant laxative that can lead to dependency if used daily, as the body may become reliant on the medication for bowel movements. Chronic use can also result in electrolyte imbalances and diminished bowel function.
B. Psyllium is a bulk-forming laxative that works by increasing the bulk of stool and does not typically lead to dependency.
C. Polyethylene glycol is an osmotic laxative that can be used daily without a significant risk of dependency, as it draws water into the bowel to facilitate stool passage.
D. Docusate sodium is a stool softener that aids in preventing constipation but does not carry a risk of dependency when used regularly.
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Correct Answer is D
Explanation
A. Hair loss is not a recognized long-term side effect of phenytoin.
B. Phenytoin is used to prevent seizures, not cause them; a reoccurrence of seizures may indicate ineffective control or medication issues, but it is not a side effect.
C. Hypertension is not typically associated with phenytoin use.
D. Gingival hyperplasia, or overgrowth of gum tissue, is a common long-term side effect of phenytoin and requires regular dental hygiene and monitoring.
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.