A client is prescribed zafirlukast (Accolate) for persistent, chronic asthma. Which nursing interventions take priority?
Standard Text: Select all that apply.
1. Instruct the client not to take aspirin while on a zafirlukast regimen.
2. Instruct the client to take zafirlukast on an empty stomach.
3. Discuss the possibility of headache.
4. Encourage the client to report any hair loss..
5. Instruct the client to prevent falls by avoiding sudden changes in position.
Correct Answer: 1,2,3
Rationale 1: Concurrent use with aspirin can significantly increase blood levels of zafirlukast, increasing the risk of adverse effects.
Rationale 2: Taking zafirlukast with food can reduce its bioavailability.
Rationale 3: Headache is the most common complaint from clients who take zafirlukast.
Rationale 4: Zafirlukast does not result in hair loss.
Rationale 5: Zafirlukast does not cause orthostatic hypotension.
Global Rationale: Zafirlukast is metabolized by CYP450 enzymes and has the potential to interact with substrates of the inhibitors of this enzyme. Use with warfarin may significantly increase prothrombin time (PT). Concurrent use with aspirin can significantly increase zafirlukast levels. Food can reduce the bioavailability; thus the drug should be taken on an empty stomach. Hair loss and orthostatic hypotension are not adverse effects.
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