NCLEX RN Practice Question # 417


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Rifampin (Rifadin) Medication


  • Rifampin inhibits bacterial RNA synthesis.
  • It binds to DNA-dependent RNA polymerase and blocks RNA transcription.
  • It is used with at least one other antitubercular medication.

Contraindications and cautions

  • Rifampin is contraindicated in clients with hypersensitivity.
  • It should be used with caution in clients with hepatic dysfunction or alcoholism.
  • Use of alcohol or hepatotoxic medications may increase the risk of hepatotoxicity.
  • Rifampin decreases the effects of several medications, including oral anticoagulants, oral hypoglycemics, chloramphenicol (Chloromycetin), digoxin (Lanoxin), disopyramide phosphate (Norpace), mexiletine (Mexitil), quinidine polygalacturonate, tocainide hydrochloride, fluconazole (Diflucan), methadone hydrochloride (Dolophine), phenytoin (Dilantin), and verapamil hydrochloride (Calan).

 Side effects

  • Hypersensitivity reaction, including fever, chills, shivering, headache, muscle and bone pain, and dyspnea
  • Heartburn, nausea, vomiting, diarrhea
  • Red-orange–colored body secretions
  • Vision changes
  • Hepatotoxicity and hepatitis
  • Increased uric acid levels
  • Blood dyscrasias
  • Colitis


  • Assess for hypersensitivity.
  • Evaluate CBC, uric acid, and liver function test results.
  • Assess for signs of hepatitis; if they occur, withhold the medication and notify the physician.
  • Monitor stools for signs of colitis.
  • Monitor mental status.
  • Assess for visual changes.

Client education

  • Instruct the client not to skip doses and to take medication for the full length of the prescribed therapy.
  • Instruct the client not to take any other medication without consulting the physician.
  • Advise the client of the importance of followup physician visits and laboratory tests.
  • Instruct the client to avoid alcohol.
  • Advise the client to take medication on an empty stomach with 8 oz of water 1 hour before or 2 hours after meals and to avoid taking antacids with the medication.

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