What should a nurse be concerned about when a patient on ketoconazole is also prescribed Rifampin?

When considering the interaction between ketoconazole and Rifampin, the primary concern is that Rifampin is a potent inducer of cytochrome P450 enzymes, particularly CYP3A4, which plays a major role in the metabolism of many drugs, including ketoconazole. When Rifampin is administered together with ketoconazole, it can significantly reduce the serum concentration of ketoconazole, leading to decreased efficacy in treating conditions for which ketoconazole is prescribed. This interaction is particularly important to monitor, as a lack of therapeutic effect from ketoconazole could result in a resurgence or worsening of the fungal infection that it is intended to treat.

This knowledge underscores the importance of understanding drug interactions and the metabolic pathways of medications. Nurses and healthcare providers must be vigilant when managing patients on these medications to ensure that therapeutic levels of ketoconazole are maintained, which may require dosage adjustments or alternative treatments.