Question

can you please provide me an answer for the questions below using the above case study .tnx

Case study: Benzodiazepines

Daria, 23 years old, is scheduled to have her wisdom teeth removed under procedural sedation with a benzodiazepine. Her friends describe her as the “life of the party” with nearly daily consumption of alcohol. She lives alone in the country, just down the road from her older adult parents.

OTHER PERTINENT INFORMATION:

Temperature - 97.7 degrees Fahrenheit

Weight - 64.5 kg

Height - 5 feet & 2 inches tall

1. What are the safety concerns for Daria?

2. What adverse effects might you expect to see in Daria’s situation?

3. If Daria does not go into work the next morning, what would be the priority action?

4. What patient teaching is essential to prevent a harmful outcome?

5. What measures would be taken if Daria comes into the emergency department unconscious from a mixture of alcohol and benzodiazepines?

6. Doctors order: Citalopram 40mg OD PO and you only have 10mg tablets of citalopram on hand. How many tablets would you administer to the patient?

7. Convert Darla's temperature into Celsius, her weight into pounds, and her height into centimeters.

Answer 1

1. What are the safety concerns for daria?

The safety concerns are:

· Using smaller amounts of the drug reduces risk of developing dependence

· Avoid regular use

· Avoid using along with alcohol, opioid and any other CNS depressants

· Watch out for dizziness, drowsiness, poor co-ordination, vision problems, headache, feelings of depression, trembling , irritability and confusion

2. What adverse effects might you expect to see in Daria’s situation?

The adverse effects are aggravated when combined with alcohol.

· drug interactions with alcohol can result in slowed breathing rates, which can restrict oxygen to the body and can lead to death

· Enhancement of the effects of both causing excessive sedation

· Increased risk of overdose

· Significant reduction in cognitive abilities resulting in loss of inhibition, risk taking behavior and impaired judgement.

· Decreased physical reactions

· Combining drugs increases the potential to develop serious acute reactions, such as heart attack, stroke, psychosis, suicidal tendencies, or seizures.

· Long-term abuse or misuse of alcohol and benzodiazepines in combination is associated with depression, trauma and stressor-related disorders, anxiety disorders, psychotic disorders, bipolar disorder, etc

· Prolonged use of either alcohol or benzodiazepines is associated with a risk to develop physical dependence.

3. If Daria does not go into work the next morning, what would be the priority action?

If Daria does not go into work the next morning the priority action would be to check on her to make sure she has not overdosed on alcohol or any prescribed drug as she stays alone.

4.What patient teaching is essential to prevent a harmful outcome?

Daria has to be made aware of :

· The risks involved with the use of benzodiazepine

· The expected feeling or effect after the drug is given to daria

· The duration how long the effect lasts

· Complications of the use of benzodiazepine

· Drug interactions with the use of benzodiazepines

· Precautions to be taken at home

· Watch out for excessive drowsiness, blurring of vision, giddiness , if any need to report to the emergency department

· Avoid taking any over the counter drugs

5.What measures would be taken if Daria comes into the emergency department unconscious from a mixture of alcohol and benzodiazepines?

· Rapid assessment of the patient's airway, breathing, and circulation.

· Continuous cardiac monitoring

· Intravenous access established – start Iv fluids

· Oxygen is administered

· Endotracheal intubation should not be delayed if needed

· Thiamine therapy initiated

· Flumazenil is a nonspecific competitive antagonist of the BZD receptor. It can be used to reverse BZD-induced sedation following general anesthesia, procedural sedation, or overdose.

· In adults, the recommended initial dose is 0.2 mg given intravenously (IV) over 30 seconds. Repeated doses of 0.2 mg, to a maximum dose of 1 mg, can be given until the desired effect is achieved.

6. Doctors order: Citalopram 40mg OD PO and you only have 10mg tablets of citalopram on hand. How many tablets would you administer to the patient?

4 tablets

7. Convert Darla's temperature into Celsius, her weight into pounds, and her height into centimeters.

Temperature : 97.7 degrees Fahrenheit

T_(°C) = (T_(°F) - 32) × 5/9

= (97.7-32) × 5/9

=36.5 degree C

Weight =64.5 kg

1kg=2.2Lb

= 64.5 × 2.2

=141.9 lb

=142 lb

Height = 5 ft & 2 inches tall

=62 inches