Comprehensive Nursing Pharmacology Q 197
Frequent eye examinations are recommended in clients receiving:
A. chloroquine
B. colchicine
C. penicillamine
D. gold compounds
Correct Answer: A. chloroquine
Corneal deposits are an adverse reaction associated with chloroquine administration, necessitating frequent eye examination. Although chloroquine has relatively few side effects when taken as prescribed, higher doses of chloroquine have been shown to have severe adverse effects. The most severe adverse effects associated with high doses of chloroquine include retinal toxicity, long and subtle symptoms of reduced visual acuity, diplopia, and bilateral loss of vision.
Option B: The most common adverse reactions are related to the gastrointestinal tract. Diarrhea is the most commonly reported symptom (23%), followed by vomiting (17%) and nausea (4% to 17%). There are reports of central nervous system symptoms such as fatigue and headache. Endocrine and metabolic conditions such as gout have been reported with the use of colchicine, as has pharyngolaryngeal pain.
Option C: Most common adverse effects of penicillamine include diarrhea and dysgeusia. 33% of patients can present with an allergic reaction to the drug. It often presents with a rash that heals on stopping the drug. The patient should stop the medication if the patient presents with fever, arthralgia, and lymphadenopathy.
Option D: The new gold compound triethyl phosphine gold (auranofin) can be partially absorbed in the gut following oral administration due to its higher lipophilic nature. This is probably also the main cause for the differences in kinetic properties versus the parenteral gold compounds. Following administration of auranofin, there are lower concentrations of gold in blood and organs; 95% of the gold is excreted in feces whereas 70% of gold, following gold sodium thiomalate, is excreted in the urine.