A nurse is caring for a patient who is taking multiple medications. To help ensure that adverse drug reactions are prevented or minimized, the nurse will do which of the following? (Select all that apply.)
a. Ask the patient about over-the-counter medications used.
b. Contact the prescriber to request cytochrome P450 levels.
c. Limit the patient's calcium intake.
d. Obtain a thorough diet history.
e. Request orders for PRN medications to treat any anticipated symptoms of drug interactions.
ANS: A, B, D
Over-the-counter medications add to drug interactions, and a thorough history of all medications taken by the patient is essential to minimize adverse drug reactions. Cytochrome P450 levels yield important information about a patient's ability to metabolize drugs and can help predict whether drugs will reach toxic levels or be ineffective. A diet history allows providers to anticipate significant known food-drug interactions. Limiting calcium intake is necessary only if the patient is taking drugs known to interact with calcium, such as tetracycline. Asking for PRN medications to treat drug reactions may only compound the risk, because the risk of drug interactions increases with the number of medications taken.
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