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Author Question: A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes ... (Read 74 times)

tfester

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on: Jul 23, 2018
A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes phenytoin (Dilantin) for seizures. The nurse will contact the provider to discuss:
 
  a. reducing the isoniazid dose.
  b. reducing the phenytoin dose.
  c. monitoring isoniazid levels.
  d. monitoring phenytoin levels.

Question 2

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially?
 
  a. Isoniazid and pyrazinamide
  b. Isoniazid, pyrazinamide, and ethambutol
  c. Rifampin, pyrazinamide, and ethambutol
  d. Isoniazid, rifampin, pyrazinamide, and ethambutol


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anyusername12131

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

ANS: D
Isoniazid is a strong inhibitor of three cytochrome P450 enzymes, and inhibition of these enzymes can raise the levels of other drugs, including phenytoin. Patients taking phenytoin should have the levels of this drug monitored, and the dose should be reduced if appropriate. Reducing the dose of isoniazid is not indicated. It is not necessary to monitor isoniazid levels.

Answer to Question 2

ANS: D
The induction phase of treatment for patients in a region without drug resistance is the same as for patients who are human immunodeficiency virus (HIV) negative or HIV positive and includes isoniazid, rifampin, pyrazinamide, and ethambutol. It is not correct to begin with two drugs. The three-drug regimen is used for inductions in areas with resistance to either isoniazid or rifampin.


tfester

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Reply #2 on: Jul 23, 2018
Both answers were spot on, thank you once again


anyusername12131

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Reply #3 on: Jul 23, 2018
Great! Please up vote :D


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