A nurse is caring for a client who has a prescription for phenelzine. The nurse should instruct the client to avoid which of the following over-the-counter medications?
A.
Pseudoephedrine
B.
Docusate sodium
C.
Ranitidine
D.
Ibuprofen
The Correct answer and Explanation is:
The correct answer is A. Pseudoephedrine.
Explanation:
Phenelzine is a monoamine oxidase inhibitor (MAOI) used primarily to treat depression. When caring for a client prescribed phenelzine, it is crucial to understand the potential interactions between MAOIs and certain over-the-counter medications. Pseudoephedrine, a common decongestant found in many cold and allergy medications, poses significant risks when taken alongside phenelzine.
Mechanism of Interaction: MAOIs, like phenelzine, inhibit the enzyme monoamine oxidase, which is responsible for the breakdown of neurotransmitters, including norepinephrine. Pseudoephedrine can increase the release of norepinephrine and other catecholamines. When these substances are combined, there is a risk of hypertensive crisis—a sudden and dangerous increase in blood pressure that can lead to severe complications, such as stroke or heart attack.
Symptoms of Hypertensive Crisis: Signs of a hypertensive crisis may include severe headache, palpitations, chest pain, and visual disturbances. If a client experiences these symptoms, immediate medical attention is required.
Recommendations for Patients: Nurses should advise clients on phenelzine to read labels carefully and avoid any medications containing pseudoephedrine or other sympathomimetics. Instead, alternative medications for nasal congestion should be recommended that do not interact with MAOIs.
Other Options:
- B. Docusate sodium: This stool softener does not interact with MAOIs and is safe for use.
- C. Ranitidine: An H2 blocker used for reducing stomach acid; it also has no known interactions with MAOIs.
- D. Ibuprofen: An NSAID for pain relief; while it should be used with caution due to potential interactions with some medications, it does not have a direct contraindication with MAOIs.
In conclusion, instructing clients to avoid pseudoephedrine while taking phenelzine is essential to prevent serious health risks associated with drug interactions.