A patient has lamivudine-sensitive hepatitis B and is taking ...

[123654777]

A patient has lamivudine-sensitive hepatitis B and is taking entecavir (Baraclude) 0.5 mg per day. The nurse reviews the patient's laboratory values and notes a creatinine clearance of 40 mL/min.
 
  What will the nurse discuss with the patient's provider?
  a. Continuing the entecavir at the same dose
  b. Decreasing the entecavir dose to 0.25 mg per day
  c. Discontinuing the entecavir and considering dialysis
  d. Increasing the entecavir dose to 1 mg per day

Question 2

A patient has a positive test for influenza type A and tells the nurse that symptoms began 5 days before being tested. The prescriber has ordered oseltamivir (Tamiflu). The nurse will tell the patient that oseltamivir:
 
  a. may decrease symptom duration by 2 or 3 days.
  b. may not be effective because of the delay in starting treatment.
  c. may reduce the severity but not the duration of symptoms.
  d. will alleviate symptoms within 24 hours of the start of therapy.

[mmpiza]

Answer to Question 1

ANS: B
Patients with a creatinine clearance of 30 to 49 mL/min should take 0.25 mg of entecavir per day. It is not correct to continue the same dose or to increase the dose. Dialysis is not indicated.

Answer to Question 2

ANS: B
Oseltamivir is most effective when begun within 2 days after symptom onset. When started within 12 hours of symptom onset, it may decrease duration of symptoms by 2 to 3 days. The drugs reduces both symptom severity and symptom duration when used in a timely fashion. It does not rapidly alleviate symptoms.

[123654777]

TYSM

[cassie_ragen]

Excellent