Podcast
Questions and Answers
A client taking zileuton reports experiencing several new symptoms. Which symptom would be most indicative of a serious adverse effect requiring immediate reporting to their healthcare provider?
A client taking zileuton reports experiencing several new symptoms. Which symptom would be most indicative of a serious adverse effect requiring immediate reporting to their healthcare provider?
- Mild headaches that are relieved with over-the-counter analgesics.
- Abdominal pain or tenderness, nausea, or anorexia. (correct)
- Occasional insomnia and mild irritability that does not impair daily functioning.
- Increased appetite and a corresponding weight gain of 2 pounds per week.
A patient with a history of well-controlled asthma is prescribed montelukast. The patient is also taking phenobarbital for a separate condition. Considering the potential interactions, what adjustment to the montelukast dosage might be necessary and why?
A patient with a history of well-controlled asthma is prescribed montelukast. The patient is also taking phenobarbital for a separate condition. Considering the potential interactions, what adjustment to the montelukast dosage might be necessary and why?
- Discontinue montelukast, as the interaction with phenobarbital is contraindicated.
- Increase the dose of montelukast, as phenobarbital can reduce montelukast levels. (correct)
- No adjustment is necessary, montelukast does not interact with phenobarbital.
- Decrease the dose of Montelukast as phenobarbital will increase the effects.
A client is prescribed warfarin for anticoagulation and is started on zafirlukast for asthma management. What is the most critical instruction to provide this client regarding the interaction between these medications?
A client is prescribed warfarin for anticoagulation and is started on zafirlukast for asthma management. What is the most critical instruction to provide this client regarding the interaction between these medications?
- Decrease the dosage of warfarin by half to prevent excessive anticoagulation and bleeding.
- There are no significant interactions between warfarin and zafirlukast, so treatment can continue as prescribed.
- Report any signs of bleeding or easy bruising to the healthcare provider immediately. (correct)
- Immediately stop taking warfarin if any signs of bleeding occur, and notify the healthcare provider.
Which statement accurately describes why leukotriene modifiers are generally not suitable for treating acute asthma exacerbations?
Which statement accurately describes why leukotriene modifiers are generally not suitable for treating acute asthma exacerbations?
A healthcare provider is considering prescribing a leukotriene modifier for a client with mild, persistent asthma. The client has a history of occasional alcohol use. Which of the following assessments is most important prior to initiating treatment with either zileuton or zafirlukast?
A healthcare provider is considering prescribing a leukotriene modifier for a client with mild, persistent asthma. The client has a history of occasional alcohol use. Which of the following assessments is most important prior to initiating treatment with either zileuton or zafirlukast?
A client with asthma is prescribed montelukast. What is the primary action of this medication in managing asthma symptoms?
A client with asthma is prescribed montelukast. What is the primary action of this medication in managing asthma symptoms?
A client is prescribed zileuton for asthma. Which laboratory test is most important to monitor regularly?
A client is prescribed zileuton for asthma. Which laboratory test is most important to monitor regularly?
A parent is asking how to administer montelukast granules to a child. Which instruction is most appropriate?
A parent is asking how to administer montelukast granules to a child. Which instruction is most appropriate?
Which statement accurately describes the difference in the mechanism of action between montelukast and zileuton?
Which statement accurately describes the difference in the mechanism of action between montelukast and zileuton?
A client reports experiencing increased anxiety and insomnia since starting montelukast. What is the nurse's best action?
A client reports experiencing increased anxiety and insomnia since starting montelukast. What is the nurse's best action?
Which client instruction regarding zafirlukast is most important to prevent potential complications?
Which client instruction regarding zafirlukast is most important to prevent potential complications?
A client is prescribed montelukast for exercise-induced bronchospasm (EIB). Which of these instructions is most appropriate?
A client is prescribed montelukast for exercise-induced bronchospasm (EIB). Which of these instructions is most appropriate?
A client who has been taking zileuton for several weeks reports a persistent headache. What should the nurse recommend?
A client who has been taking zileuton for several weeks reports a persistent headache. What should the nurse recommend?
Flashcards
Headaches after leukotriene modifiers?
Headaches after leukotriene modifiers?
Analgesics can help.
Neuropsychiatric adverse effects include?
Neuropsychiatric adverse effects include?
Anxiety, agitation, insomnia, irritability.
Signs of liver damage with zileuton/zafirlukast?
Signs of liver damage with zileuton/zafirlukast?
Abdominal pain/tenderness, nausea, anorexia.
Which drugs may require HIGHER montelukast doses?
Which drugs may require HIGHER montelukast doses?
Signup and view all the flashcards
Key adverse effect of zileuton to report?
Key adverse effect of zileuton to report?
Signup and view all the flashcards
Leukotriene Modifiers
Leukotriene Modifiers
Signup and view all the flashcards
Montelukast
Montelukast
Signup and view all the flashcards
Leukotriene Modifier Actions
Leukotriene Modifier Actions
Signup and view all the flashcards
Liver Damage Risk
Liver Damage Risk
Signup and view all the flashcards
Neuropsychiatric Risks
Neuropsychiatric Risks
Signup and view all the flashcards
Montelukast Administration
Montelukast Administration
Signup and view all the flashcards
Montelukast for EIB
Montelukast for EIB
Signup and view all the flashcards
Reporting Symptoms
Reporting Symptoms
Signup and view all the flashcards
Study Notes
- Leukotriene modifiers are oral medications used as adjunctive therapy to reduce bronchoconstriction and inflammation.
- They treat allergic rhinitis, asthma, and exercise-induced bronchospasm.
Prototype and Other Medications
- Montelukast is the prototype leukotriene modifier.
- Zileuton and zafirlukast are other leukotriene modifiers with specific adverse effects.
Expected Pharmacologic Action
- Leukotrienes cause allergic reactions like airway inflammation and mucus production.
- Leukotriene modifiers suppress leukotriene effects.
- Zileuton inhibits leukotriene production, reducing inflammation.
- Montelukast and zafirlukast are leukotriene antagonists that prevent leukotriene activation, decreasing inflammation.
Adverse Drug Reactions
- Zileuton and, less frequently, zafirlukast may cause liver damage.
- Montelukast does not commonly cause significant side effects.
- All leukotriene modifiers carry a slight risk of neuropsychiatric effects like suicidal thoughts or behaviors.
Interventions
- Zileuton and zafirlukast require monitoring due to potential liver damage.
- Monitor liver function tests for clients taking zileuton and zafirlukast.
- Mild analgesics can be used for headaches after administration.
Administration
- Administer montelukast orally once daily in the evening as a tablet, chewable tablet, or oral granules.
- For oral granules, mix with applesauce, cooked carrots, rice, or ice cream, or place directly on the tongue.
- Administer montelukast at least 2 hours before exercise to prevent exercise-induced bronchospasm and not again for 24 hours.
Client Instructions
- Instruct clients taking zileuton or zafirlukast to report abdominal pain or tenderness, nausea, or anorexia immediately.
- Encourage clients to use over-the-counter analgesics for headaches.
- Clients and families should watch for behavioral changes such as anxiety, agitation, insomnia, or irritability, which could indicate neuropsychiatric adverse effects.
- Monitor for behavioral changes indicating suicidal ideation or depression.
Safety Alert
- Clients taking zileuton and zafirlukast are at risk for liver damage.
- Instruct them to report abdominal pain or tenderness, nausea, or anorexia immediately.
- Schedule regular liver function tests to reduce the risk of liver injury.
Contraindications and Precautions
- Do not give zileuton and zafirlukast to clients with liver dysfunction.
- Leukotriene modifiers are not for acute asthma exacerbations or status asthmaticus.
- Use with caution in clients with severe asthma due to the higher efficacy of other medications.
Interactions
- Clients taking phenobarbital, rifampin, or phenytoin may need higher doses of montelukast.
- Zileuton and zafirlukast can increase levels of warfarin.
- Zileuton can also increase levels of theophylline and propranolol.
Safety Alert
- Instruct clients to inform their provider if they are taking zileuton or zafirlukast because these medications interact with several other medications, particularly warfarin.
- Concurrent administration of zileuton and zafirlukast with warfarin can increase warfarin's anticoagulant effects, causing bleeding and hemorrhage.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Leukotriene modifiers reduce bronchoconstriction and inflammation. Montelukast is a prototype. Zileuton inhibits leukotriene production, reducing inflammation. Montelukast and zafirlukast are leukotriene antagonists that prevent leukotriene activation, decreasing inflammation.
