A 43-year-old man undergoes a kidney transplantation. His physician prescribes azathioprine for graft rejection prophylaxis. His past medical history is significant for gouty arthritis. Which of the following antigout drugs should he avoid while taking azathioprine?

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ATI Pharmacology Made Easy 4.0 Infection Questions

Question 1 of 5

A 43-year-old man undergoes a kidney transplantation. His physician prescribes azathioprine for graft rejection prophylaxis. His past medical history is significant for gouty arthritis. Which of the following antigout drugs should he avoid while taking azathioprine?

Correct Answer: A

Rationale: Azathioprine, metabolized by xanthine oxidase, interacts with allopurinol , which inhibits this enzyme. This raises azathioprine levels, risking toxicity. Colchicine , Indomethacin , and Prednisolone don't affect this pathway. Probenecid (E) is safe. Avoiding allopurinol prevents immunosuppression complications.

Question 2 of 5

The nurse is caring for a client receiving amphotericin B for a fungal infection. Which adverse effect should the nurse monitor closely?

Correct Answer: A

Rationale: Amphotericin B, an antifungal, is nephrotoxic , damaging renal tubules and reducing GFR, a severe effect needing close monitoring (e.g., creatinine, urine output) to adjust dosing or hydration. Ototoxicity , hepatotoxicity , and cardiotoxicity are less common. Nephrotoxicity's frequency and severity align with amphotericin's membrane-binding mechanism, critical in fungal infections where prolonged use is typical, making A the priority to monitor for renal protection.

Question 3 of 5

At what point does atropine hit its peak for IM injections?

Correct Answer: A

Rationale: Atropine given via intramuscular (IM) injection typically reaches its peak effects within 15 to 50 minutes after administration. The onset of action is relatively rapid, with faster absorption and distribution compared to oral administration. The effects of atropine can be seen within minutes, reaching peak concentration within the specified time frame. This rapid onset is important clinically when atropine is used to treat conditions such as bradycardia or nerve agent poisoning where a quick response is needed.

Question 4 of 5

Which statement is accurate regarding pharmacotherapy in the older adult?

Correct Answer: B

Rationale: Aging reduces liver/renal clearance, raising plasma levels (e.g., digoxin), heightening response and toxicity risk, per pharmacokinetics. Body water drops, concentrating drugs, not diluting. Doses decrease, not increase-metabolism slows. Absorption may slow, but pH rises, not falls. Plasma increase drives effects, key in elders.

Question 5 of 5

The client takes diphenhydramine (Benadryl) but forgets to tell the physician about this drug when a monoamine oxidase inhibitor (MAOI) drug is prescribed for depression. What will the best assessment by the nurse reveal?

Correct Answer: D

Rationale: Diphenhydramine, an antihistamine with anticholinergic properties, interacts dangerously with MAOIs, which inhibit monoamine breakdown. This combination can cause a hypertensive crisis due to excessive norepinephrine from inhibited metabolism, a life-threatening risk requiring urgent assessment. Depression persistence relates to MAOI efficacy, not interaction. Seizures are less common than hypertensive effects. Allergy control isn't the primary concern. The nurse's best assessment focuses on hypertensive crisis, a well-documented MAOI interaction, prioritizing immediate safety and intervention.

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