A patient asks the nurse to tell her more about a new drug the patient has been prescribed called ranolazine (Ranexa). Which response by the nurse is accurate?

Choice A rationale Ranolazine (Ranexa) is an antianginal agent that works by inhibiting the late sodium current in cardiac myocytes. This inhibition leads to a reduction in intracellular calcium overload, improving myocardial relaxation and reducing ventricular wall tension. Unlike many other antianginal drugs, ranolazine does not significantly affect heart rate or blood pressure, making it useful in patients who cannot tolerate the hemodynamic effects of other agents. Choice B rationale Ranolazine is not a first-line therapy for angina. It is typically used as a second-line treatment in patients who have not achieved adequate symptom control with beta-blockers, calcium channel blockers, or nitrates. It is often prescribed in combination with other antianginal drugs. Choice C rationale Ranolazine is an oral medication available in an extended-release tablet formulation. It is not administered intravenously. The patient takes this medication by mouth, usually twice daily, for the long-term management of chronic angina. Choice D rationale Ranexa is metabolized by the liver, specifically via the cytochrome P450 3A (CYP3A) enzyme pathway. Therefore, it is contraindicated or requires significant dose adjustment in patients with moderate to severe hepatic impairment due to the risk of increased plasma concentrations and toxicity.