A college student is brought into the emergency department for ...

[james9437]

A college student is brought into the emergency department for treatment after friends say that she took at least 20 antidepressant pills all at once.
 
  A nurse should be most concerned that of all the antidepressants, which of the following could lead to the worst outcome for the patient?
  a. Venlafaxine (Effexor)
  b. Fluoxetine (Prozac)
  c. Paroxetine (Paxil)
  d. Sertraline (Zoloft)

Question 2

A patient taking amitriptyline (Elavil) is brought to the emergency department confused and agitated.
 
  As time progresses, her assessment reveals a heart rate of 120/minute, temperature 104 F, flushing, mydriasis, and blood pressure 170/90. Based on her assessment, which of the following would be the nurse's priority action?
  a. Gastric lavage, activated charcoal, and physostigmine
  b. Epinephrine and propranolol (Inderal)
  c. Gastric lavage, activated charcoal
  d. Cool IV fluids and a cooling blanket

[Sassygurl126]

Answer to Question 1

ANS: A
Venlafaxine can cause dose-related, sustained diastolic hypertension, a medical crisis for the patient.
Fluoxetine, paroxetine, and sertraline, all selective serotonin reuptake inhibitors, may do harm to the patient when taken in such a large dose, but death by overdose is extremely rare.

Answer to Question 2

ANS: A
Amitriptyline overdose should be suspected based on the patient's assessment findings. The patient should be treated with gastric lavage, followed by ingestion of activated charcoal, which will bind with the medication so that it is removed from the body. Physostigmine is given to counteract the anticholinergic actions of the amitriptyline.
Epinephrine and propranolol are not indicated as treatment for amitriptyline overdose. There is no reason to suspect that alcohol toxicity is the issue.
Physostigmine should be included as part of the management of amitriptyline overdose.
Bringing down the patient's temperature is not indicated for amitriptyline overdose.

[james9437]

TYSM

[cici]

Thanks for the timely response, appreciate it