The nurse provides discharge instructions to a patient prescribed verapamil [Calan] SR 120 mg PO daily for essential hypertension. Which statement by the patient indicates understanding of the medication?
A. "I will take the medication with grapefruit juice each morning."
B. "I should expect occasional loose stools from this medication."
C. "I'll need to reduce the amount of fiber in my diet."
D. "I must make sure I swallow the pill whole."
Ans: D. "I must make sure I swallow the pill whole."
Explanation: SR" indicates that the drug is sustained release; therefore, the patient must swallow the pill intact, without chewing or crushing, which would result in a bolus effect. Grapefruit juice should be avoided, because it can inhibit intestinal and hepatic metabolism of the drug, thereby raising the drug level. Constipation, not loose stools, is a common side effect of Calan; increasing fluids and dietary fiber can help prevent this adverse effect.
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