A client with myasthenia gravis is receiving pyridostigmine (Mestinon). Which medications should the nurse question prior to administering to this client?
Standard Text: Select all that apply.
1. Decadron
2. Ibuprofen
3. Warfarin
4. NPH insulin
5. Lidocaine
Correct Answer: 1,2,5
Rationale 1: Cholinergic drugs increase gastric acid secretion and should be used with caution with corticosteroids such as Decadron.
Rationale 2: Cholinergic drugs increase gastric acid secretion and should be used with caution with nonsteroidal anti-inflammatory drugs such as ibuprofen.
Rationale 3: Warfarin administration does not need to be questioned for the client with myasthenia gravis.
Rationale 4: NPH insulin administration does not need to be questioned for the client with myasthenia gravis.
Rationale 5: Drugs that interfere with neuromuscular transmission such as lidocaine should be used with caution in the client with myasthenia gravis because severe muscular weakness may result.
Global Rationale: Cholinergic drugs increase gastric acid secretion and should be used with caution with corticosteroids such as Decadron and nonsteroidal anti-inflammatory drugs such as ibuprofen. Drugs that interfere with neuromuscular transmission such as lidocaine should be used with caution in the client with myasthenia gravis because severe muscular weakness may result. Warfarin administration and NPH insulin administration do not need to be questioned for the client with myasthenia gravis.
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