Pharmacology Quiz 2 NU 160

Correct Answer:

A. Jaw pain

B. Tinnitus

C. Blurred vision

D. Dysphagia

Explanation of the Correct Answers:

A. Jaw pain:

Jaw pain is a serious side effect associated with bisphosphonates like alendronate, particularly because it can be a sign of osteonecrosis of the jaw. This condition is a rare but severe complication that can result from bisphosphonate therapy and requires prompt medical attention.

B. Tinnitus:

Tinnitus (ringing in the ears) is a possible side effect of alendronate, though it is not very common. It could indicate an issue with the medication and should be reported to the healthcare provider.

C. Blurred vision:

Blurred vision can be a sign of ocular toxicity, which, although rare, is a potential adverse effect of alendronate. If the client experiences any vision changes, it should be reported to the provider.

D. Dysphagia:

Dysphagia (difficulty swallowing) is a known side effect of bisphosphonates like alendronate, especially if the medication is not taken with sufficient water or the client lies down shortly after taking it. Difficulty swallowing could lead to esophageal irritation or even ulceration, so it is important to report this to the provider.

Why the Other Option Is Incorrect:E. Drowsiness:

Drowsiness is not a common or serious side effect of alendronate. It is not typically associated with the medication, and unless the client experiences extreme fatigue or unusual symptoms, drowsiness does not need to be reported.

Summary:

The nurse should instruct the client to report jaw pain, tinnitus, blurred vision, and dysphagia as these can indicate serious adverse effects like osteonecrosis of the jaw, ocular toxicity, or esophageal irritation. Drowsiness is not a typical side effect of alendronate and does not require immediate attention unless other symptoms develop.

Correct Answer C: Tremors

Explanation of the Correct Answer:

Albuterol is a beta-2 agonist commonly used to treat asthma and chronic obstructive pulmonary disease (COPD) by relaxing the muscles in the airways and increasing airflow to the lungs. While it is an effective bronchodilator, it can cause several side effects due to its systemic effects.

Tremors (C): One of the most common side effects of albuterol is tremors. These are typically fine shakes or tremors in the hands and fingers, which occur because albuterol stimulates beta-2 receptors not just in the lungs, but also in other parts of the body, including skeletal muscles. This can lead to muscle twitching or tremors, especially at higher doses.

Why the Other Options Are Incorrect:

A. Nausea : Nausea is not as common as tremors with albuterol use, though it can occur. It’s more likely to be seen if the medication is used in excess or if the patient is sensitive to the drug.

B. Headache : Headache can be a side effect of albuterol, but it is less common than tremors. Headaches may result from the vasodilation effects or other systemic effects of the drug.

D. Drowsiness : Drowsiness is not a common side effect of albuterol. In fact, albuterol is more likely to cause symptoms like nervousness or restlessness due to its stimulating effects on the beta-2 receptors. It does not generally cause sedation or drowsiness.

Summary:

The most common side effect of albuterol is tremors. Although nausea, headache, and drowsiness can occur, they are less frequent compared to tremors

Correct Answer C: Dry mouth

Explanation of the Correct Answer:

Ipratropium is an anticholinergic medication commonly used in the management of chronic obstructive pulmonary disease (COPD) and asthma. A common side effect of anticholinergic medications, including ipratropium, is dry mouth. This occurs due to the inhibition of acetylcholine, which reduces salivation. Clients should be informed that this is a typical and manageable side effect.

Why the Other Options Are Incorrect:

A. Drowsiness

Incorrect. Ipratropium is not known to cause drowsiness. It is a bronchodilator and does not have sedative effects, which makes drowsiness an uncommon side effect.

B. Muscle tremors

Incorrect. Muscle tremors are more commonly associated with medications like beta-agonists (e.g., albuterol), not ipratropium. Ipratropium does not typically cause muscle tremors.

D. Increased salivation

Incorrect. Ipratropium works by blocking acetylcholine, leading to a decrease in salivation, not an increase. Increased salivation is not a side effect of ipratropium.

Summary:

The nurse should inform the client that dry mouth is a common side effect of ipratropium and advise the client on ways to manage it, such as drinking water or using sugar-free gum or lozenges.

Correct Answer:

A. Calcium carbonate

E. Aluminum hydroxide

Explanation of the Correct Answers:

A. Calcium carbonate:

Calcium carbonate is a common antacid used to relieve symptoms of heartburn or indigestion. One of its side effects is constipation. Calcium can reduce the motility of the gastrointestinal tract, leading to slower bowel movements. This is especially notable in individuals who take high doses of calcium carbonate, such as those using it as a calcium supplement or frequently for acid reflux.

E. Aluminum hydroxide:

Aluminum hydroxide, often found in antacids like Maalox and Mylanta, can also cause constipation. It has a tendency to slow down the passage of stool through the intestines. This is one of the reasons that aluminum-based antacids are sometimes combined with magnesium-based ones to balance their side effects.

Why the Other Options Are Incorrect:

B. Magnesium oxide:

Magnesium oxide is used for its antacid properties but is more likely to cause diarrhea, not constipation. Magnesium salts, in general, have a laxative effect and can promote bowel movements. Therefore, magnesium oxide is not associated with constipation.

C. Magnesium hydroxide:

Like magnesium oxide, magnesium hydroxide is known for its laxative effect. It works by drawing water into the intestines to stimulate bowel movements. It is commonly used in over-the-counter medications like Milk of Magnesia, and constipation is not a typical side effect.

D. Sodium bicarbonate:

Sodium bicarbonate, commonly known as baking soda, is used to neutralize stomach acid and can temporarily relieve heartburn. It does not typically cause constipation. In fact, it is more likely to cause symptoms like belching or bloating due to the release of carbon dioxide. It does not slow down bowel movements in the way calcium or aluminum-based antacids do.

Summary:

The antacids that can cause constipation are calcium carbonate and aluminum hydroxide. Both of these medications can slow gastrointestinal motility, leading to fewer bowel movements. Magnesium-based antacids, on the other hand, typically cause diarrhea, while sodium bicarbonate does not usually affect bowel movements.

Correct Answer B: Inspect your mouth for lesions daily.

Explanation of the Correct Answer:

Fluticasone is an inhaled corticosteroid (ICS) used for the long-term control of chronic obstructive pulmonary disease (COPD) and asthma. It helps reduce inflammation in the airways, making breathing easier over time.

One of the potential side effects of inhaled corticosteroids like fluticasone is the development of oral thrush, which is a fungal infection that can cause lesions in the mouth. It is important for the client to inspect their mouth daily for any signs of white patches, sores, or irritation. If these symptoms occur, the client should report them to their healthcare provider, as they may need treatment with antifungal medication. Rinsing the mouth with water after using the inhaler can help prevent this side effect.

Why the Other Options Are Incorrect:

A. Skip the morning dose if you do not have any symptoms. 

This is not a recommended instruction. Fluticasone is a maintenance medication used regularly to control inflammation and symptoms over time. Even if the client does not have symptoms, it is important to use the medication as prescribed. Skipping doses could reduce its effectiveness in managing the condition.

C. Use this medication to relieve an asthma attack.

This is incorrect. Fluticasone is a preventive medication, not a rescue medication. It does not provide immediate relief during an asthma attack. For acute attacks, the client should use a short-acting beta-agonist (SABA), such as albuterol, which works quickly to open the airways.

D. Check your heart rate before each dose.

Checking the heart rate is not typically necessary for fluticasone use. Fluticasone does not have significant effects on heart rate. However, if the client is taking other medications that could affect the heart rate (such as certain bronchodilators), they might need to monitor their heart rate, but it is not required for fluticasone itself.

Summary:

The correct instruction is B because oral thrush is a common side effect of inhaled corticosteroids like fluticasone. Checking the mouth for lesions daily helps detect and prevent this issue early.

Correct Answer:

A. The medication will open the airways.

D. The medication will prevent wheezing.

E. The medication will decrease coughing episodes.

Explanation of the Correct Answers:

A. The medication will open the airways.

Albuterol is a beta-2 agonist that works by relaxing the smooth muscles around the airways, leading to bronchodilation. This helps open the airways, making it easier for the person to breathe, which is why albuterol is used in the treatment of conditions like asthma and COPD.

D. The medication will prevent wheezing.

By opening the airways, albuterol can prevent wheezing, which is commonly caused by constricted or narrowed airways. Wheezing is a hallmark symptom of asthma and other respiratory conditions, and albuterol helps alleviate it by improving airflow.

E. The medication will decrease coughing episodes.

Although albuterol is primarily used to alleviate wheezing and shortness of breath by opening the airways, it can indirectly reduce coughing episodes as well. This is because coughing can often be triggered by constricted or narrowed airways, and by improving airflow, albuterol can make breathing easier, thus reducing coughing that may be associated with bronchoconstriction.

Why the Other Options Are Incorrect:

B. The medication will reduce inflammation.

Albuterol is a bronchodilator, not an anti-inflammatory drug. While it helps open up the airways, it does not directly reduce inflammation in the airways. Medications like steroids are used for that purpose, but albuterol itself does not have an anti-inflammatory effect.

C. The medication will stimulate flow of mucus.

Albuterol does not stimulate mucus production. It works by relaxing the muscles of the airways to allow for easier breathing, but it does not directly affect mucus production or clearance. Mucus flow and secretion are typically managed by other types of treatments, such as expectorants.

Summary:

Albuterol opens the airways, prevents wheezing, and can reduce coughing by improving airflow. It does not directly reduce inflammation or stimulate mucus flow. Therefore, the correct answers are A, D, and E.

Correct Answer D: Avoid driving until effects are known.

Explanation of the Correct Answer:

Cyclobenzaprine is a centrally acting skeletal muscle relaxant commonly prescribed to treat acute muscle spasms associated with musculoskeletal conditions. It works by depressing motor activity primarily in the brainstem, leading to muscle relaxation. One of the most important safety considerations when starting cyclobenzaprine is its sedative effect, which can cause drowsiness, dizziness, and impaired cognitive or motor performance.

Because of these central nervous system effects, clients are advised to avoid driving, operating heavy machinery, or engaging in hazardous activities until they understand how the drug affects them individually. This is particularly crucial during the initial stages of treatment or when the dose is increased, as sedation may be pronounced.

Why the Other Options Are Incorrect:

A. Monitor for increased muscle spasms

Incorrect. Cyclobenzaprine is used to reduce muscle spasms, not increase them. If spasms worsen, it may indicate an ineffective response, but it is not a common or expected adverse effect of the drug.

B. Discontinue medication if nausea occurs.

Incorrect. Nausea is a relatively mild and non-life-threatening side effect of cyclobenzaprine. It should not be a reason for abrupt discontinuation. Instead, clients should report persistent or severe nausea to their provider, who may adjust the dose or provide supportive measures.

C. Expect urine to turn orange

Incorrect. Orange discoloration of urine is associated with medications like phenazopyridine, not cyclobenzaprine. This is not an expected or typical side effect of this muscle relaxant.

Summary:

The nurse should teach the client to avoid driving until the effects of cyclobenzaprine are known, due to its potential to cause sedation and impair motor and cognitive function, especially during the initial treatment period.

Correct Answer B: The medication will relieve muscle spasms that might occur with a fracture.

Explanation of the Correct Answer:

Cyclobenzaprine is a muscle relaxant primarily used to treat muscle spasms associated with acute musculoskeletal conditions, such as fractures. It works by acting on the central nervous system to reduce muscle tone and spasms. When a fracture occurs, muscle spasms can often result as the body reacts to injury, and cyclobenzaprine helps alleviate this discomfort.

Why the Other Options Are Incorrect:

A. Cyclobenzaprine will relieve any nausea associated with a fracture.

Incorrect. Cyclobenzaprine is not used to treat nausea. Nausea can sometimes occur with fractures due to pain or medications like opioids, but cyclobenzaprine does not address this symptom.

C. Cyclobenzaprine will reduce itching that might occur as the fracture begins to heal.

Incorrect. Itching during the healing process of a fracture is typically related to the formation of a scab or callus over the fracture site or from the immobilization (e.g., casting). Cyclobenzaprine does not have any effect on itching.

D. The medication will fight microorganisms that can cause infection at the fracture site.

Incorrect. Cyclobenzaprine does not have antibiotic properties. It does not fight infections. If infection prevention is needed, the client would require an antibiotic, not a muscle relaxant.

Summary:

Cyclobenzaprine is used to relieve muscle spasms associated with fractures or musculoskeletal injuries, making option B the correct explanation for the nurse to provide to the client.

Correct Answer B: The medication should be applied on a regular schedule for the rest of the client’s life.

Explanation of the Correct Answer:

Timolol is a beta-adrenergic blocker used in the form of ophthalmic drops to treat open-angle glaucoma, a condition in which elevated intraocular pressure (IOP) can damage the optic nerve and lead to permanent vision loss.

Timolol works by reducing the production of aqueous humor, thereby lowering IOP. However, glaucoma is a chronic condition and does not go away, even if the pressure returns to normal. Because of this, long-term, consistent treatment is essential to prevent progression of the disease and preserve vision.

Patients should be instructed that timolol must be used daily and continuously, even if they do not have symptoms. Stopping the medication can cause a rebound increase in intraocular pressure, which can worsen optic nerve damage.

Why the Other Options Are Incorrect:

A. The medication is not used for just 10 days or tapered off. This would be dangerous in the management of glaucoma, which requires lifelong treatment.

C. Timolol is not used as-needed for eye pain. It is a maintenance therapy, not a rescue or symptom-based medication. Also, glaucoma is often asymptomatic in the early stages.

D. The goal is to maintain normal intraocular pressure, not to stop treatment once the pressure is controlled. Discontinuing therapy risks pressure elevation and optic nerve damage.

Summary:

The correct teaching is that timolol eye drops should be used on a regular schedule for life, as open-angle glaucoma is a chronic disease requiring ongoing management to prevent vision loss.