Author Question: The client has been prescribed duloxetine (Cymbalta) for the treatment of diabetic neuropathic pain. ... (Read 21 times)

nevelica · **on:** Jul 23, 2018

The client has been prescribed duloxetine (Cymbalta) for the treatment of diabetic neuropathic pain. What information should the nurse provide to this client?

Standard Text: Select all that apply.
1. The prescription is for a small number of capsules because the medication will be discontinued if it doesn't work in a week.
2. This is a corticosteroid, so you may notice an increased thirst.
3. Your dose is lower than your wife's because her prescription is for a different reason.
4. You may feel relief in as few as 5 days.
5. This drug is a narcotic, so be certain to keep it in a safe place.

Question 2

The client has been keeping a headache diary of her migraines. Upon review of this diary, the nurse notes that the headaches are described as mild and have happened four times in the last 3 months.

The client reports that she generally just lies down until they pass but that her new job will not allow that time. She is requesting information about pain medication. What medications would the nurse expect to be prescribed?
Standard Text: Select all that apply.
1. Ibuprofen
2. Acetaminophen and caffeine
3. Sumatriptan (Imitrex)
4. Ergotamine (Ergostat)
5. Amitriptyline (Elavil)

tranoy · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,3,4
Rationale 1: If improvement in pain relief is not noted in 1 week, the drug is discontinued.
Rationale 2: Duloxetine is an antidepressant, not a corticosteroid.
Rationale 3: Duloxetine is also given as an antidepressant, and that dose is generally higher.
Rationale 4: The effects of the drug usually occur in 57 days.
Rationale 5: Duloxetine is not a narcotic.
Global Rationale: If improvement in pain relief is not noted in 1 week, the drug is discontinued. Duloxetine is also given as an antidepressant, and that dose is generally higher. The effects of the drug usually occur in 57 days. Duloxetine is an antidepressant, not a corticosteroid. Duloxetine is not a narcotic.

Answer to Question 2

Correct Answer: 1,2
Rationale 1: NSAIDs are often effective for the mild migraines this client experiences.
Rationale 2: Acetaminophen and caffeine together are used for treatment of mild migraines.
Rationale 3: Sumatriptan is a serotonin receptor agonist and is usually used only for moderate to severe migraines.
Rationale 4: Ergotamine is an ergot alkaloid that is a serotonin receptor agonist. This drug is used only with moderate to severe migraines.
Rationale 5: Amitriptyline is used to prevent migraines, not to reduce pain once they occur.
Global Rationale: NSAIDs are often effective for the mild migraines this client experiences. Acetaminophen and caffeine together are used for treatment of mild migraines. Sumatriptan is a serotonin receptor agonist and is usually used only for moderate to severe migraines. Ergotamine is an ergot alkaloid that is a serotonin receptor agonist. This drug is used only with moderate to severe migraines. Amitriptyline is used to prevent migraines, not to reduce pain once they occur.