The nurse is providing multiple medications to a patient whose ...

[leilurhhh]

The nurse is providing multiple medications to a patient whose spouse brings him grapefruit juice every morning. The nurse should be concerned about which classes of drugs? (Select all that apply.)
 
  a. Calcium channel blockers
  b. Selective serotonin reuptake inhibitors
  c. Aminoglycosides
  d. Beta blockers
  e. Penicillins

Question 2

The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites.
 
  As a result of this concurrent administration, the nurse can anticipate that what might occur? (Select all that apply.)
  a. Binding of one or both agents is reduced.
  b. Plasma levels of free drug will rise.
  c. Plasma levels of free drug will fall.
  d. The increase in free drug can intensify effects.
  e. The increase in bound drug can intensify effects.

[wergv]

Answer to Question 1

ANS: A, B
Calcium channel blockers and selective serotonin reuptake inhibitors have been shown to reach increased and/or toxic levels when taken with grapefruit juice. Grapefruit juice is not contraindicated with aminoglycosides, beta blockers, or penicillins.

Answer to Question 2

ANS: A, B, D
When two drugs bind to the same site on plasma albumin, coadministration of those drugs produces competition for binding. As a result, binding of one or both agents is reduced, causing plasma levels of free drug to rise. The increase in free drug can intensify the effect, but it usually undergoes rapid elimination. The increase in plasma levels of free drug is rarely sustained.

[leilurhhh]

Excellent

[juliaf]

TYSM