The nurse administers sulfamethoxazole and trimethoprim (Bactrim) for a desirable client response derived from the combination of agents. Which type of medication effect does the nurse anticipate?

Question

1. Tolerance
2. Synergistic
3. Dependence
4. Subtherapeutic

Answer 1

2
2. The nurse anticipates a synergistic effect from Bactrim because the two antibiotics, SMZ/TMP, work better in combination than either agent works as monotherapy.
1. Drug tolerance means a larger and larger dose of medication is needed to produce the same therapeutic effect over time.
3. Drug dependence is psychological or physical. The client takes the medication for another effect other than the therapeutic effect, resulting in psychological depen-dence. Physical dependence is involves physiological adaptation to the medication that results in severe adverse effects if withdrawn abruptly.
4. A subtherapeutic effect is a less than therapeutic effect; the therapy treats the dis-order inadequately, potentially includes client injury, and usually results from a sub-therapeutic dose. Example: The provider prescribes warfarin 2.5 mg for the client, but a 5 mg dose is required for a therapeutic response (i.e., adequate anticoagulation). The low warfarin dose has a mild and inadequate effect on coagulation and leaves the client exposed to the risk of a thromboembolic event.