Correct (2): Zafirlukast and zileuton carry hepatotoxicity warnings. Symptoms — fatigue, RUQ pain, jaundice, dark urine, clay-colored stools — strongly suggest cholestatic liver injury. Hold the drug, notify provider, urgent LFT (AST/ALT/bilirubin). (1) Not asthma symptoms. (3) Higher dose worsens liver injury. (4) Cholestyramine without diagnosis is inappropriate.
Clinical scenario
Scenario 45-year-old female on zafirlukast 20 mg PO BID × 3 months for chronic asthma. Now reports fatigue, RUQ pain, dark urine, clay-colored stools, scleral icterus.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.