quick vallium question

Nurses General Nursing

Published

I have a quick question about giving valium to a teenager. I was taking care of a teen this week with suspected meningitis and bronchitis. He was prescribed valium q 6. Acetaminophen prn for fever.

Well, i did know to keep track of the acetaminophen since it is in valium too. I'm a student by the way. He was allowed to have a max of 4g per day (same as adult)...but my question is should i question this order since valium also has an antitussive effect? Wouldnt we want him to keep coughing up the yellow sputum that he had? Lungs were diminished already. I asked my instructor and she said no it wouldnt really do that much for his cough??? I dont really always trust her answers so I thought I would ask here. I've tried to research it but cant really find an answer either way. Thanks

0 Votes
Specializes in Critical Care.

There's no acetaminophen in valium (diazepam).

Nor does diazepam have a significant antitussive effect.

Are you sure you aren't confusing it for vicodin (hydrocodone/acetaminophen)?

0 Votes
Specializes in Utilization Management.

There is no acetaminophen in valium.

http://www.medicinenet.com/diazepam/article.htm

0 Votes

I'm sorry its been a few days. Vicodin for pain.

0 Votes

i guess typing the correct drug will help my research huh? Student who has just realized how easy med errors could really be. ugh

0 Votes

The real lesson here is don't work when you're tired. ;)

0 Votes
Specializes in Critical Care.

To answer your question, you are right to consider the amount of acetaminophen you are administering when the patient has both vicodin and tylenol ordered. As for its antitussive properties, it's really a judgment call. You need to consider the pain your client may or may not be experiencing.

---

Interestingly enough, I went and researched and it turns out that diazepam can have an antitussive effect via binding to dextromorphan receptors in addition to its muscle relaxant properties, but it is poorly studied.

0 Votes

yup, i'm tired right now. Yeah for spring break.

He had other things ordered for pain but it was morphine. He was in pain so i did want to give it to him...just not sure when i would question it.

0 Votes

Some day I'll understand why my colleagues write for these idiotic Tylenol + Vicodin orders.

A tab of Vicodin has 500mg acetaminophen, which is the same as an extra-strength Tylenol. You give 2 tabs of Vicodin and you just gave a gram of tylenol.

So what ends up happening every time? The patient complains of pain, gets some Tylenol, still has pain, and can't get the narcs they need because they're already at the max dose of acetaminophen for the day. And of course this always happens right around 3am.

Percocet + ibuprofen = good

OxyIR + tylenol = better

Vicodin + tylenol = dumb

0 Votes
Specializes in Critical Care.
Some day I'll understand why my colleagues write for these idiotic Tylenol + Vicodin orders.

A tab of Vicodin has 500mg acetaminophen, which is the same as an extra-strength Tylenol. You give 2 tabs of Vicodin and you just gave a gram of tylenol.

So what ends up happening every time? The patient complains of pain, gets some Tylenol, still has pain, and can't get the narcs they need because they're already at the max dose of acetaminophen for the day. And of course this always happens right around 3am.

Percocet + ibuprofen = good

OxyIR + tylenol = better

Vicodin + tylenol = dumb

Is there a particular reason why hydrocodone is considered schedule II and essentially unavailable when alone? It almost seems like they buffer it with acetaminophen to try and deter overdosing on it, which is silly: I think most people would appreciate dying from an opioid overdose over dying from acute liver failure (especially when the former is far more reversible!). :)

It seems like vicoprofen would be more in vogue due to its mild anti-inflammatory effect, anyways.

0 Votes
Is there a particular reason why hydrocodone is considered schedule II and essentially unavailable when alone? It almost seems like they buffer it with acetaminophen to try and deter overdosing on it, which is silly: I think most people would appreciate dying from an opioid overdose over dying from acute liver failure (especially when the former is far more reversible!). :)

It seems like vicoprofen would be more in vogue due to its mild anti-inflammatory effect, anyways.

Not too sure why so many of these narcs are available as stand-alone products. There is that "synergy" theory that NSAIDs/tylenol in combination with narcs complement each other to provide superior pain relief.

And certainly, other than the overdose factor, acetaminophen is a far safer drug overall. The NSAIDs have the gastric problems, potential renal failure, potentially contribute to heart disease, and at least theoretically can exacerbate bleeding issues.

But yeah, not a clue why no hydrocodone on it's own. If given the option, I would probably utilize that before oxycodone, given the addiction/abuse profiles.

0 Votes

i'm more concerned if the antitussive effect would really do anything to interfere with his bronchitis.

0 Votes
+ Add a Comment