👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Pharmacological Therapies🔖 Free to read, print, and share
Also known as: Singulair · leukotriene blocker · asthma maintenance pill
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Use this quick-reference guide to spot, treat, and prevent Montelukast on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Uses
Asthma maintenance, allergic rhinitis
Blocks leukotrienes → ↓ inflammation
✅ Do
Take daily in evening
Exercise dose ≥ 2 hr before
📌 Avoid
NOT for acute attack → no rescue
Keep rescue inhaler on hand
🚩 Report
Mood change, suicidal thoughts
Worsening wheeze despite use
📚 Montelukast — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Montelukast is a leukotriene receptor antagonist that blocks inflammatory leukotrienes to prevent bronchoconstriction. It is taken daily for long-term asthma control and allergic rhinitis, NOT for an acute attack. Memory aid: '-lukast' = leukotriene blocker.
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Key points
Understand these first
It is a controller/prophylactic drug and does NOT relieve an acute bronchospasm or asthma attack.
Given orally once daily, typically in the evening, with or without food.
Effective for both asthma and seasonal/perennial allergic rhinitis, and prevents exercise-induced bronchospasm.
Has a black box warning for serious neuropsychiatric events including agitation, depression, and suicidal thinking.
Chewable tablets contain phenylalanine, a concern for patients with phenylketonuria (PKU).
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Nursing priorities
What to do, in order
Confirm the patient understands this is daily prevention, not rescue, and continues to carry a short-acting bronchodilator.
Assess and document baseline mood and behavior; monitor for new agitation, depression, or suicidal ideation.
Administer in the evening for asthma to align with overnight/early-morning symptoms.
Screen chewable forms for phenylalanine content in patients with PKU.
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Red flags — report now
Escalate immediately
Report new or worsening mood changes, agitation, hallucinations, or suicidal thoughts immediately.
Never substitute montelukast for a rescue inhaler during an acute attack.
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Patient teaching
What patients must know
Take it every day even when you feel well; it works by preventing symptoms over time.
Keep using your rescue inhaler for sudden breathing trouble.
Report any unusual mood, sleep, or behavior changes to your provider.
❓ Montelukast: NCLEX FAQs
What are the priority nursing interventions for Montelukast?
Confirm the patient understands this is daily prevention, not rescue, and continues to carry a short-acting bronchodilator. Assess and document baseline mood and behavior; monitor for new agitation, depression, or suicidal ideation. Administer in the evening for asthma to align with overnight/early-morning symptoms. Screen chewable forms for phenylalanine content in patients with PKU.
What are the warning signs of Montelukast a nurse must report?
Report new or worsening mood changes, agitation, hallucinations, or suicidal thoughts immediately. Never substitute montelukast for a rescue inhaler during an acute attack.
What do I need to know about Montelukast for the NCLEX?
It is a controller/prophylactic drug and does NOT relieve an acute bronchospasm or asthma attack. Given orally once daily, typically in the evening, with or without food. Effective for both asthma and seasonal/perennial allergic rhinitis, and prevents exercise-induced bronchospasm. Has a black box warning for serious neuropsychiatric events including agitation, depression, and suicidal thinking.
What patient teaching is important for Montelukast?
Take it every day even when you feel well; it works by preventing symptoms over time. Keep using your rescue inhaler for sudden breathing trouble. Report any unusual mood, sleep, or behavior changes to your provider.
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Quick Tip
It is a controller/prophylactic drug and does NOT relieve an acute bronchospasm or asthma attack.