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1.2.9: Develop and implement individualized treatment plans, taking into consideration allergies

What appropriate premedication regimen is recommended for administration prior to the administration of paclitaxel?

(A) Dexamethasone and ranitidine

(B) Ranitidine and diphenhydramine

(C) Dexamethasone and diphenhydramine

(D) Dexamethasone, ranitidine, and diphenhydramine

The Correct Answer is: D

A combination of a corticosteroid and an H1 and H2 antagonist (D) are recommended for administration prior to paclitaxel infusions, to decrease the incidence and severity of hypersensitivity reactions to paclitaxel.

Answers a, b, and c are incorrect.

Which glaucoma medication class should be avoided in patients with a sulfa allergy?

(A) Prostaglandin analogs

(B) Beta-blockers

(C) Calcium channel blockers

(D) Carbonic anhydrase inhibitors

The correct answer is (D).

Carbonic anhydrase inhibitors (D) contain a sulfa moiety, and should be avoided in patients with a sulfa allergy.

Prostaglandin analogs (A), beta-blockers (B), and calcium channel blockers (C) can be administered to patients with sulfa allergies.

What medication should be given to a patient before receiving paclitaxel?

(A) Filgrastim

(B) Diphenhydramine

(C) Amifostine

(D) Dexrazoxane

The Correct Answer is: B

Paclitaxel is associated with severe hypersensitivity reactions. If a hypersensitivity reaction occurs stop the infusion. Do not rechallenge, especially if hypotension requiring treatment or angioedema occurs. Premedication with dexamethasone, diphenhydramine (B), and ranitidine is recommended.

While paclitaxel can cause a neutropenia, administration of filgrastim (A) should not be given prior to the development of the myelosuppression. Cisplatin and carboplatin may cause nephrotoxicity and can be prevented by the administration of fluids and amifostine (C). Dexrazoxane (D) prevents the cardiac toxicity caused by anthracyclines.


What is the medication contraindicated in patients with documented sulfa allergy?

(A) Ultram

(B) Toradol

(C) Celebrex

(D) Aspirin

(E) Hyaluronic acid

The Correct Answer is: C

An allergy to sulfa is a contraindication to celecoxib (C).

Tramadol (A) and Toradol (B) may be taken in patients with a history of sulfa allergy. Aspirin (D) and hyaluronic acid (E) are not contraindicated in patients with a sulfa allergy.


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