A patient takes an antispasmodic and an occasional antidiarrheal ...

[imanialler]

A patient takes an antispasmodic and an occasional antidiarrheal medication to treat IBS. The patient comes to the clinic and reports having dry mouth, difficulty urinating, and more frequent constipation.
 
  The primary care NP notes a heart rate of 92 beats per minute. The NP should: a. prescribe a TCA.
  b. discontinue the antidiarrheal medication.
  c. encourage the patient to increase water intake.
  d. lower the dose of the antispasmodic medication.

Question 2

A patient who has a previous history of renal stones will begin taking probenecid for gout. The primary care NP should:
 
  a. add colchicine to the patient's drug regimen.
  b. counsel the patient to use high-dose aspirin for pain.
  c. teach the patient to drink plenty of acidic fluids such as juice.
  d. tell the patient to stop taking the medication when symptoms subside.

[briezy]

Answer to Question 1

D
Patients taking antispasmodic medications should be monitored for anticholinergic side effects, such as increased heart rate, dry mouth, difficulty urinating, and constipation. The NP should lower the dose if needed. TCAs are used to treat pain long-term. Because the antidiarrheal medication is used as needed, there is no reason to discontinue it. Increasing water intake may improve symptoms associated with side effects but would not treat the underlying cause of these symptoms.

Answer to Question 2

A
Patients at risk for urinary stones may take colchicine along with probenecid to reduce the risk caused by probenecid. Salicylates and acidic urine increase the risk. The medication must be tapered 6 months after the last acute attack.

[imanialler]

Gracias!

[peter]

TYSM