A nurse is reviewing a patient's medications prior to administration. Which drug-to-drug interactions should most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?
a. Furosemide (Lasix) and enalapril (Vasotec)
b. Amlodipine (Norvasc) and spironolactone (Aldactone)
c. Eplerenone (Inspra) and spironolactone (Aldactone)
d. Metoprolol (Lopressor) and furosemide (Lasix)
ANS: C
The greatest risk with eplerenone is hyperkalemia, and combining this drug with a potassium-sparing diuretic creates a significant risk of hyperkalemia.
Furosemide and enalapril, an ACE inhibitor, would not be contraindicated in this patient.
Amlodipine and spironolactone would not cause hyperkalemia.
The combination of metoprolol, a beta blocker, and furosemide would not be contraindicated in this patient.
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