A primary care NP is planning to order a macrolide antibiotic for ...

[cool]

A primary care NP is planning to order a macrolide antibiotic for a patient who is experiencing an exacerbation of chronic obstructive pulmonary disease. The patient is taking a cytochrome (CYP) 3A medication. The NP should order:
 
  a. azithromycin.
  b. clarithromycin.
  c. erythromycin base.
  d. erythromycin estolate.

Question 2

A patient reports having feelings of hopelessness and anxiety for the past few months. The primary care nurse practitioner (NP) performs a history and learns that these feelings occur almost daily.
 
  The patient also reports having headaches and difficulty concentrating at work along with wanting to sleep all the time. The patient has gained 5 lb in the past 6 months. The NP should: a. tell the patient that these symptoms should resolve on their own.
  b. reassure the patient that these are symptoms of minor depression.
  c. tell the patient that an exercise regimen alone should be effective.
  d. assess the patient for alcohol and drug use and for suicidal ideation.

[dantucker]

Answer to Question 1

A
Azithromycin does not interact with other CYP 3A medications. Erythromycin and clarithromycin do.

Answer to Question 2

D
The patient is having symptoms of major depression, but other factors such as drug or alcohol abuse that may be contributing to the diagnosis must be ruled out first. Patients should be asked about suicidal ideation so that measures can be taken to prevent a suicide attempt. Symptoms of major depression require treatment. Exercise should be a part of any plan but should not be the only intervention.

[cool]

Excellent

[dantucker]

TYSM