The nurse is reviewing medication orders for a client and anticipates that which medications may cause adverse effects due to their extended half-life caused by enterohepatic recirculation?
Standard Text: Select all that apply.
1. Digoxin
2. Morphine
3. Demerol
4. Fentanyl
5. Estrogen
Correct Answer: 1,2,5
Rationale 1: Certain drugs, including digoxin, are eliminated in the bile and reabsorbed by enterohepatic recirculation, which recycles the drug multiple times and can significantly extend a drug's half-life and cause increased adverse effects.
Rationale 2: Certain drugs, including morphine, are eliminated in the bile and reabsorbed by enterohepatic recirculation, which recycles the drug multiple times and can significantly extend a drug's half-life and cause increased adverse effects.
Rationale 3: Demerol does not have an extended half-life.
Rationale 4: Fentanyl does not have an extended half-life.
Rationale 5: Certain drugs, including estrogen, are eliminated in the bile and reabsorbed by enterohepatic recirculation, which recycles the drug multiple times and can significantly extend a drug's half-life.
Global Rationale: Certain drugs, including digoxin (Lanoxin), morphine, and estrogens, are eliminated in the bile and are reabsorbed by enterohepatic recirculation. Enterohepatic recirculation recycles the drug multiple times and can significantly extend a drug's half-life. Interactions can occur if one drug interferes with the enterohepatic recycling of another drug. Demerol and fentanyl are not affected by enterohepatic circulation.
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