A patient who is an opioid addict has undergone detoxification ...

[dalyningkenk]

A patient who is an opioid addict has undergone detoxification with buprenorphine (Subutex) and has been given a prescription for buprenorphine with naloxone (Suboxone). The patient asks the nurse why the drug was changed.
 
  Which response by the nurse is correct?
  a. Suboxone has a lower risk of abuse.
  b. Suboxone has a longer half-life.
  c. Subutex causes more respiratory depression.
  d. Subutex has more buprenorphine.

Question 2

A patient who is a heroin addict is admitted to a methadone substitution program. After administering the first dose of methadone, the nurse notes that the patient shows signs of euphoria and complains of nausea. What will the nurse do?
 
  a. Administer nalmefene (Revex).
  b. Contact the provider to obtain an order for naloxone (Narcan).
  c. Question the patient about heroin use that day.
  d. Suspect that the patient exaggerated the amount of heroin used.

[iceage]

Answer to Question 1

ANS: A
The combination of buprenorphine and naloxone (Suboxone) discourages intravenous abuse, because with IV use, the naloxone precipitates withdrawal; this effect does not occur with sublingual dosing (Subutex). Suboxone does not differ from Subutex in terms of drug half-life. Subutex does not cause more respiratory depression and does not contain more buprenorphine.

Answer to Question 2

ANS: D
Patients entering a methadone substitution program must be carefully questioned about the amount of heroin used; patients may exaggerate the amount used to obtain higher doses of methadone or may minimize the amount used to downplay the extent of their addiction. In patients who exaggerate use, the amount of methadone given may cause euphoria, nausea, and vomiting. Nalmefene and naloxone are used to treat overdose and are not indicated. A patient receiving methadone along with a usual heroin dose would be likely to have signs of toxicity.

[dalyningkenk]

Excellent

[tkempin]

TYSM