# A client with ulcerative colitis starting mesalamine asks the nurse about expected adverse effects. Which response is most accurate?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391817&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client with ulcerative colitis starting mesalamine asks the nurse about expected adverse effects. Which response is most accurate?

## Option

1. Expect significant weight gain
2. No adverse effects with this drug
3. Monitor for headache, nausea, flank pain (interstitial nephritis), and rare hypersensitivity; baseline and periodic BUN/Cr and LFT recommended **✔ Correct answer**
4. Expect daily severe constipation

**Correct answer: 3**

## Explanation

Correct (2): Mesalamine (5-ASA) commonly causes headache, GI upset, and rash; serious effects include interstitial nephritis, pancreatitis, and rare hypersensitivity that may mimic UC flare. Baseline/periodic BUN/Cr/LFT monitoring. (1,3,4) Incorrect.

## In-depth explanation

Memory Tip 5-ASA = "Mesa-LAMINE = LAMINate the colon" anti-inflammatory; renal vigilance critical. Sulfasalazine adds sulfa allergy + folate deficiency.

## Clinical scenario

Scenario 32-year-old female with ulcerative colitis starting mesalamine 1.2 g PO TID. Outpatient teaching.

## Key concepts

- **Mesalamine (5-ASA)** — Topical anti-inflammatory for UC and mild Crohn; PO, enema, suppository.
- **Interstitial nephritis** — Renal inflammation; insidious; monitor BUN/Cr periodically.
- **5-ASA preparations** — Oral mesalamine, sulfasalazine, balsalazide, olsalazine.

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