What is the major reason that monoamine oxidase inhibitors (MAOIs) are rarely used in clinical practice today?
They are under a scheduled drug classification.
They are ineffective in treating depression or anxiety disorders.
They can cause gastrointestinal (GI) bleeding and esophageal varices.
They may cause dangerous interactions with some foods and drugs.
The Correct Answer is D
A. While MAOIs may have some regulatory considerations, they are not classified under a scheduled drug classification like controlled substances.
B. MAOIs are effective in treating depression and anxiety disorders, which is not the reason for their limited use.
C. Although MAOIs can have some side effects, they are more notably associated with dietary and drug interactions rather than causing GI bleeding or esophageal varices.
D. MAOIs can cause dangerous interactions with foods that contain tyramine (like aged cheeses and fermented products) and certain medications, leading to hypertensive crises, making their use cautious and limiting in clinical practice.
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Correct Answer is D
Explanation
A. Nitrates do not share a cross-sensitivity with penicillin and are safe to use in this client.
B. Tetracycline is a different class of antibiotics and does not have cross-sensitivity with penicillin.
C. Aminoglycosides also do not have cross-sensitivity with penicillin and can be safely administered.
D. Cephalosporins are structurally related to penicillin and have a risk of cross-sensitivity; thus, they should not be given to a client with a history of anaphylaxis to penicillin.
Correct Answer is A
Explanation
A. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." is correct; St. John's wort can reduce the effectiveness of SSRIs and may increase the risk of serotonin syndrome, making it vital for the nurse to address this safety concern.
B. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." is a valid point, but it does not specifically address the interaction with the client’s current medication.
C. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." is misleading; the concern is not just about timing but about taking both together at all.
D. "It's very important that you comply with your prescribed treatment." while true, this response does not directly address the specific risks associated with combining St. John's wort and citalopram.