A patient who has been taking linezolid (Zyvox) for 6 months ...

[cookcarl]

A patient who has been taking linezolid (Zyvox) for 6 months develops vision problems. What will the nurse do?
 
  a. Reassure the patient that this is a harmless side effect of this drug.
  b. Tell the patient that blindness is likely to occur with this drug.
  c. Tell the patient that this symptom is reversible when the drug is discontinued.
  d. Tell the patient to take tyramine supplements to minimize this effect.

Question 2

A patient is taking erythromycin ethylsuccinate for a chlamydial infection and develops vaginal candidiasis. The prescriber orders ketoconazole to treat the suprainfection. What will the nurse do?
 
  a. Administer the erythromycin and the ketoconazole as ordered.
  b. Contact the provider to discuss changing to a different antifungal medication.
  c. Contact the provider to discuss increasing the dose of erythromycin.
  d. Contact the provider to suggest using erythromycin stearate.

[kusterl]

Answer to Question 1

ANS: C
Linezolid is associated with neuropathy, including optic neuropathy. This is a reversible effect that will stop when the drug is withdrawn. Reassuring the patient that this is a harmless side effect is not correct. It is not an indication that blindness will occur. Tyramine supplements are not indicated.

Answer to Question 2

ANS: B
Erythromycin can prolong the QT interval when present in large concentrations. When erythromycin is combined with a CYP3A4 inhibitor, such as ketoconazole, the risk of sudden cardiac death increases fivefold. The nurse should discuss changing the antifungal medication to one that is not a CYP3A4 inhibitor. It is not correct to give the ketoconazole without questioning the order. Increasing the dose of erythromycin would increase the risk of QT prolongation. Changing to a different preparation of erythromycin would not alter the risk.

[cookcarl]

Excellent

[juliaf]

TYSM