Question

A nurse is providing teaching for a client who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. Which of the following instructions should the nurse include? Increase the rifampin dose. Increase the oral contraceptive dose. Allow 2 hr between taking the two drugs. Use a non-hormonal form of contraception

Answer 1

1. Rifampin is the only one antibiotic which will  reduce the plasma estrogen levels.The common content of most of the contraceptives are estrogen. If Rifampin therapy is given to a patients on oral contraceptive regimen, it will reduce the estrogen level in blood which reduce the effectiveness of oral contraceptives.So, a non- hormonal contraceptive method is mandatory.

Thus, the answer is D) Use non- hormonal form of contraception

2. Metronidazole can cause disulfiram like reactions due to accumulation of toxic substance acetaldehyde in the blood when alcohol or alcohol based products are used during mertronidazole treatment. It is better to avoid these products, three days following last dose of this medicine to avoid undesired effects.

thus, the answer is D) Metronidazole

3. Acyclovir is excreted through kidneys by glomerular filtration and tubular secretion.If the patient is dehydrated, it can cause crystalluria due to formation of precipitates and cause damage and acute renal failure.  

Thus the answer is B) Dehydration

4. Imipenum can cause oral thrust as an adverse effect.It is due to the overgrowth of fungus, yeast or  bacteria in the oral cavity.The symptoms include pain and burning sensation of mouth,cracked skin in mouth and lining. These type of infections commonly seen as a complication of antibiotic treatment, is known as superinfection.

Thus the answer is B) Superinfection

5.Gentamicin administered along with ethacrynic acid may cause additive ototoxicity due to increased plasma and tissue concentration of gentamicin by ethacrynic acid

the answer is A) ethacrynic acid

6.Erythromycin can cause cardiac dysrythmias due to QT prolongation. Thus the nurse should monitor for cardiac dysrythms.

Thus, the answer is D) cardiac dysrythmias

7.Co-administration of warfarin with trimethoprim/sulfamethoxazole can cause increase in plasma concentration of warfarin which leads to bleeding. Thus the nurse should clarify with the provider about the concurrent use of these drugs.

Thus, the answer is A) Bleeding