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Author Question: A patient who is taking ketoconazole tells the nurse that her periods have become irregular. What ... (Read 14 times)

Destiiny22

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on: Jul 23, 2018
A patient who is taking ketoconazole tells the nurse that her periods have become irregular. What will the nurse tell her?
 
  a. This indicates that she should begin taking oral contraceptives.
  b. This is caused by a reversible effect on estradiol synthesis.
  c. This is a serious side effect that warrants discontinuation of the drug.
  d. This is a sign of hepatic toxicity, and the drug dose should be lowered.

Question 2

A provider has ordered oral voriconazole Vfend for a patient who has a systemic fungal infection. The nurse obtains a medication history and learns that the patient takes phenobarbital for seizures.
 
  The nurse will contact the provider to discuss which possibility? a. Administering intravenous voriconazole
  b. Reducing the dose of phenobarbital
  c. Reducing the dose of voriconazole
  d. Using a different antifungal agent


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olderstudent

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Reply #1 on: Jul 23, 2018
Answer to Question 1

B
Ketoconazole inhibits steroid synthesis in humans, and in females it reduces estradiol synthesis, causing menstrual irregularities. It is not an indication that oral contraceptive pills (OCPs) are needed. Because it is reversible, there is no indication for withdrawing the drug until treatment is complete. Menstrual irregularities are not a sign associated with hepatotoxicity.

Answer to Question 2

D
Voriconazole can interact with many drugs. It should not be combined with drugs that are po-werful P450 inhibitors, including phenobarbital, because these can reduce the levels of vorico-nazole. Administering the voriconazole IV will not increase the serum level. It is not correct to reduce the dose of either drug.


Destiiny22

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Reply #2 on: Jul 23, 2018
Thanks


olderstudent

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Reply #3 on: Jul 23, 2018
Welcome :)


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