A nurse provides teaching to a patient who is about to receive a first dose of fingolimod (Gilenya). Which statement by the patient indicates a need for further teaching?
a. "I may experience a rapid heart rate and palpitations with the first dose."
b. "I should report nausea, vomiting, poor appetite, and dark urine."
c. "I will need an ophthalmologic examination before beginning treatment."
d. "I will need to remain in an observation unit for 6 hours after the first dose."
ANS: A
Tachycardia and palpitations are not adverse effects associated with fingolimod. Nausea and vomiting (N/V), anorexia, and dark urine are associated with liver injury related to fingolimod and should be reported. Macular edema may occur, so a baseline ophthalmologic examination should be performed. Bradycardia may occur, which diminishes after the first dose. Patients receiving the first dose should be observed for 6 hours before going home.
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