This topic contains a solution. Click here to go to the answer
« previous next »

Author Question: A patient has been taking fluoxetine (Prozac) for depression and comes to the clinic to report ... (Read 68 times)

theo

  • Hero Member
  • *****
  • Posts: 698
on: Jul 24, 2018
A patient has been taking fluoxetine (Prozac) for depression and comes to the clinic to report nausea and jitteriness. The primary care NP notes tremors and sees that the patient is confused. The patient has a heart rate of 95 beats per minute.
 
  The NP should: a. change to bupropion (Wellbutrin).
  b. ask the patient about other medications.
  c. discontinue the fluoxetine immediately.
  d. add mirtazapine (Remeron) to treat anxiety.

Question 2

A patient is taking levofloxacin to treat sinusitis. The patient calls the primary care NP to report pain just above the heel of the right foot. The NP should:
 
  a. change to ofloxacin.
  b. change to ciprofloxacin.
  c. discontinue the levofloxacin.
  d. reassure the patient that this is a common side effect.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

jojobee318

  • Sr. Member
  • ****
  • Posts: 298
Reply #1 on: Jul 24, 2018
Answer to Question 1

B
Serotonin syndrome is a potentially lethal set of symptoms such as these. The NP should evaluate whether the patient is taking other SSRIs, monoamine oxidase inhibitors, bupropion, serotonin-norepinephrine reuptake inhibitors, or other medications that can precipitate this. Changing medication is not indicated. Patients should never abruptly discontinue an SSRI. Adding mirtazapine is not indicated.

Answer to Question 2

C
Warnings have been issued for the fluoroquinolone antibiotics for the increased risk of tendon ruptures. Ruptures have occurred unilaterally and bilaterally, and have involved the Achilles tendon; however, ruptures in the shoulder joint, hand, biceps, thumb, and other tendon sites have been reported. The risk of tendon rupture is further increased in those over age 60, those receiving concomitant steroid therapy, and in kidney, heart, and lung transplant recipients. Reasons for tendon ruptures also include physical activity or exercise, kidney failure, and tendon problems in the past. These ruptures may occur during therapy or up to several months after discontinuation of drugs.


theo

  • Member
  • Posts: 698
Reply 2 on: Jul 24, 2018
Great answer, keep it coming :)

ktidd

  • Member
  • Posts: 319
Reply 3 on: Yesterday
Thanks for the timely response, appreciate it

« previous next »
 

Did you know?

Lower drug doses for elderly patients should be used first, with titrations of the dose as tolerated to prevent unwanted drug-related pharmacodynamic effects.

Did you know?

All adults should have their cholesterol levels checked once every 5 years. During 2009–2010, 69.4% of Americans age 20 and older reported having their cholesterol checked within the last five years.

Did you know?

Studies show that systolic blood pressure can be significantly lowered by taking statins. In fact, the higher the patient's baseline blood pressure, the greater the effect of statins on his or her blood pressure.

Did you know?

The first oral chemotherapy drug for colon cancer was approved by FDA in 2001.

Did you know?

The highest suicide rate in the United States is among people ages 65 years and older. Almost 15% of people in this age group commit suicide every year.

Tattoos and Body Piercings: This patient developed cellulitis from tattoo ink Tattoos and Body Piercings: This patient developed cellulitis from tattoo ink
Bipolar disease. The term bipolar means “pertaining to two poles.” The individual with this form of Bipolar disease. The term bipolar means “pertaining to two poles.” The individual with this form of
After the death of a loved one, family members report concerns about last place of care. After the death of a loved one, family members report concerns about last place of care.
Promoting Adherence in the Older Adult Patient Promoting Adherence in the Older Adult Patient
Blocking of serotonin reuptake by fluoxetine (Prozac). Blocking of serotonin reuptake by fluoxetine (Prozac).
After multiple injections of a local anesthetic, the patient developed herpetic lesions. After multiple injections of a local anesthetic, the patient developed herpetic lesions.
Video: Summation - defined, spatial, temporal & AP generation or not

For a complete list of videos, visit our video library