A patient is diagnosed with septic shock and is being evaluated ...

[RODY.ELKHALIL]

A patient is diagnosed with septic shock and is being evaluated for administration of drotrecogin alfa (Xigris). Which of the following factors would absolutely contraindicate administration of the drug to this patient?
 
  a. The patient's INR is 2.
  b. The patient experienced a hemorrhagic stroke 1 month ago.
  c. The patient has been receiving aspirin (81 mg) daily for the past week.
  d. The patient had been receiving warfarin (Coumadin) up until 1 week ago.

Question 2

A graduate nurse, in conjunction with the registered nurse, is caring for a patient who has been diagnosed with amyotrophic lateral sclerosis (Lou Gehrig's disease).
 
  The nurse asks the graduate nurse, What neurotransmitter would be most affected by riluzole (Rilutek)? Which of the following would be a correct response by the graduate nurse?
  a. Dopamine
  b. Glutamate
  c. GABA
  d. Norepinephrine

[joewallace]

Answer to Question 1

ANS: B
Hemorrhagic stroke within the previous 3 months is an absolute contraindication to administration of drotrecogin alfa. Bleeding is the most common and serious side effect of this medication.
Drotrecogin alfa should be used with caution in patients with an international normalized ratio (INR) greater than 3.
Drotrecogin alfa should be used with caution in patients who have taken more than 650 mg of aspirin within the past 7 days.
Drotrecogin alfa should be used with caution in patients who have taken warfarin within the past 7 days.

Answer to Question 2

ANS: B
Glutamate is most affected by riluzole, which can act as an antagonist.
Dopamine, gamma-aminobutyric acid (GABA), and norepinephrine are not affected by riluzole.