A nurse is caring for a client receiving insulin detemir 10 units at bedtime. Which of the following drugs, if started, would most likely require a decrease in the dosage of insulin? Select all that apply
A) Sulfamethoxazole/trimethoprim (Septra)
B) Metoprolol (Lopressor)
C) Fenofibrate (Tricor)
D) Diltiazem (Verapamil)
E) Albuterol (Ventolin)
Ans: A, B, C
Feedback:
Sulfonamides (sulfamethoxazole/trimethoprim), beta-blocking drugs (metoprolol), and fibrates (fenofibrate), among others, can increase the effect of insulin and require a decrease in insulin dosage to control the client's diabetes. Diltiazem and albuterol decrease the effect of insulin, requiring an increase in the dosage.
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