What potential interaction should a nurse be aware of when a client is prescribed fluconazole?

Fluconazole is known to influence the metabolism of various drugs due to its effects on cytochrome P450 enzymes. In the case of digoxin, fluconazole can enhance its effects by increasing plasma levels of this cardiac glycoside. This interaction occurs because fluconazole inhibits the enzyme systems that metabolize digoxin, leading to an increased risk of digoxin toxicity. This is significant because digoxin is used in treating heart conditions like atrial fibrillation and heart failure, where maintaining appropriate drug levels is crucial for ensuring safety and efficacy.

The other interactions presented do not hold true in this context. Fluconazole typically does not decrease the effects of warfarin but may actually potentiate its effects, which could lead to an increased risk of bleeding. While there is a potential for oral contraceptives to lose effectiveness due to interaction with some antifungals, fluconazole is not considered to have a clinically significant impact on hormonal contraceptives. As for benzodiazepines, while there could be increased sedation if they are metabolized by the same pathways as fluconazole, this is less commonly discussed in the literature compared to the interaction with digoxin. Thus, awareness of how fluconazole may elevate the effects of