A client with persistent asthma has a history of multiple allergies, including peanuts and soy. The nurse knows that, given this history, which prophylactic medication should be avoided?
1. Cromolyn (Intal)
2. Ipratropium (Atrovent)
3. Triamcinolone (Azmacort)
4. Zafirlukast (Accolate)
Correct Answer: 2
Rationale 1: Cromolyn does not contain soy or peanut products.
Rationale 2: Ipratropium contains a substance derived from soya lecithin, so it is contraindicated in the presence of soy allergies.
Rationale 3: Triamcinolone does not contain soy or peanut products.
Rationale 4: Zafirlukast does not contain soy or peanut products.
Global Rationale: Ipratropium is contraindicated in patients with hypersensitivity to soya lecithin or related food products such as soybean and peanut. Soya lecithin is used as a propellant in the inhaler. Cromolyn, triamcinolone, and zafirlukast do not contain soy or peanut products.
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