When reviewing a patient’s medical records, the nurse finds that the patient had developed an idiosyncratic reaction to aspirin. What should the nurse infer?
a. The therapeutic index of the drug may have been high.
b. The patient may have taken an excess dose of the drug.
c. The patient may have taken the drug with grapefruit juice.
d. The patient may have a deficiency of drug-metabolizing enzymes.
Ans: d. The patient may have a deficiency of drug-metabolizing enzymes.
Explanation: An idiosyncratic reaction occurs unexpectedly in certain patients. It is a genetically determined reaction and occurs when a patient has a deficiency or excess of drug-metabolizing enzymes. Patients with a glucose-6-phosphate dehydrogenase deficiency may have idiosyncratic reactions to drugs such as aspirin. A high therapeutic index does not cause idiosyncratic reactions. Taking a drug in excess will result in an overdose and lead to toxicity of the drug. Taking certain drugs with grapefruit juice may cause increased effects of the drug.
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