The nurse is assessing a client who regularly takes an oral first-generation antihistamine for nasal allergies. Which medication order would trigger concerns about drug interaction with the antihistamine?
1. Hydrochlorothiazide, a diuretic
2. Tylenol with codeine, an opiate analgesic
3. Enoxaparin (Lovenox), an anticoagulant
4. Atenolol, an antihypertensive
Correct Answer: 2
Rationale 1: Hydrochlorothiazide does not interact with antihistamines.
Rationale 2: First-generation antihistamines cross the blood–brain barrier and can cause drowsiness. Codeine is a narcotic that also causes drowsiness, so there will be an additive effect.
Rationale 3: Lovenox does not interact with antihistamines.
Rationale 4: Atenolol does not interact with antihistamines.
Global Rationale: First-generation antihistamines can cause significant drowsiness as can narcotics such as codeine. The additive effect may suppress respirations. The remaining drugs do not interact adversely with antihistamines.
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