A patient has received an initial dose of glatiramer acetate ...

[Yolanda]

A patient has received an initial dose of glatiramer acetate (Copaxone) for relapsing-remitting multiple sclerosis. The nurse notes that the patient appears flushed and anxious and has urticaria.
 
  The patient reports palpitations, chest pain, and a feeling of laryngeal constriction. What will the nurse do?
  a. Obtain an order for epinephrine to treat a hypersensitivity reaction.
  b. Prepare to provide cardiorespiratory support.
  c. Report a possible cardiotoxic episode to the provider.
  d. Stay with the patient until this self-limiting episode passes.

Question 2

A nurse is caring for an older adult patient who has Alzheimer's disease. The patient is taking a cholinesterase inhibitor drug. Which side effects would concern the nurse?
 
  a. Confusion and memory impairment
  b. Dizziness and headache
  c. Nausea, vomiting, and diarrhea
  d. Slowed heart rate and lightheadedness

[olivia_paige29]

Answer to Question 1

ANS: D
About 10 of patients taking glatiramer acetate experience a self-limited postinjection reaction characterized by flushing, palpitations, severe chest pain, anxiety, laryngeal constriction, and urticaria; the episode usually lasts 15 to 20 minutes. No treatment is required, but the nurse should stay with the patient to help alleviate anxiety associated with this reaction. Epinephrine is not indicated. Cardiorespiratory support is not necessary. This does not represent a cardiotoxic reaction.

Answer to Question 2

ANS: D
Cardiovascular effects of cholinesterase inhibitor drugs are uncommon but cause the most concern. Bradycardia and fainting can occur when cholinergic receptors in the heart are activated. Confusion and memory impairment are signs of the disease and are not side effects of the drug. Dizziness, headache, nausea, vomiting, and diarrhea are all expected adverse effects, and although uncomfortable, they do not present an increased risk to the patient.

[Yolanda]

Excellent

[recede]

Gracias!