The patient is receiving several medications that are contraindicated with each other. Bosentan is a strong CYP450 inducer, so it increases the metabolism of praziquantel, leading to faster clearing and decreased blood levels. Praziquantel is used for the treatment of schistosomiasis, which presents with flu-like symptoms and myalgia. Because bosentan decreases blood levels of praziquantel, the nurse expects the symptoms of schistosomiasis to worsen. Bosentan (used for pulmonary arterial hypertension) and glyburide (used for treatment of type 2 diabetes mellitus) each increase the metabolism of the other, leading to decreased levels, and therefore effectiveness, of the drug. A decreased oxygen requirement and work of breathing would be associated with therapeutic levels of bosentan, not subtherapeutic levels caused by coadministration of glyburide. Additionally, jitteriness, diaphoresis, and decreased level of consciousness are symptoms of hypoglycemia. These would be expected if glyburide levels were increased, not decreased. Ergotamine poisoning presents with decreased peripheral pulses and sensation with desquamation of the soles of the feet. However, bosentan decreases (not increases) ergotamine levels, so they would not cause toxicity.