Can you give these together...

Balder_LPN, LPN · Oct 17, 2005

From drugs.com drug interaction tool

zolpidem and acetaminophen-hydrocodone (moderate Drug-Drug)

Description:

MONITOR:

Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT:

During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be made aware of the possibility of additive CNS effects (e.g., drowsiness, dizziness, lightheadedness, confusion) and counseled to avoid activities requiring mental alertness until they know how these agents affect them. Patients should also be advised to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

Editorial Team / Admin · Oct 17, 2005

If a patient has a med schedule for Ambien at 2100 and also requests a Vicodin PRN at the same time is that okay?
OR
If a patient has a scheduled me for Ativan at 2100 and requests a vicodin PRN is it okay to give.
I'm asking because it seems like patients are attempting to knock themselves out at night, sometimes I rather then have one thing or the other but if they are in pain... I don't know what to do...
~Crystal.

Hello, Crystal. :balloons: Yes, it is o.k. to give the two together. One for sleep and the other for pain. Unless there is a contraindication or the healthcare provider states otherwise.

CoffeeRTC, BSN, RN · Oct 17, 2005

Yep...alot of my pts take a sleeper and pain med at hs prn.

gypsyatheart · Oct 17, 2005

Are you using you unit's drug books to look this info up? Is there an interaction between the drugs? Another resource is pharmacy, but I never call them until I have made an effort to look up the med and find the answer out for myself. Or are you asking if it's OK that the patient wants these meds and are you justified in giving them?

In that case if it is the appropriate time for a sleep med, administer it, if the pt. is requesting it. And for pain, are you using your pain assessment scale? Offerring "non-drug" alternatives....and documenting such? If their pain level is over what they feel comfortable with, and they are requesting the meds, you should give it.

KrysyRN, BSN · Oct 17, 2005

Whenever I have med questions like yours, I'll contact the pharmacist at/for the facility and ask them. They are great resources! :)

DianeS, RN · Oct 17, 2005

A lot of times where I work we give pain meds and sleepers together.

truern · Oct 18, 2005

Patients can be in pain and STILL sleep....so yeah, I'd give them both.

meownsmile, BSN, RN · Oct 18, 2005

I wouldnt have a problem giving them both if the patient was already established their tolerance for it,say haveing it throughout the day.

I think giving both at the same time if it is the first dose of either should warrent at least vital check within the hour after taking and several checks over the next 4 hours.

DutchgirlRN, ASN, RN · Oct 18, 2005

I would give both of them. It wouldn't bother me.

When I used to work nights I couldn't believe how much medications some of the patients would take at HS. At first I would question some of these combinations. I remember more than once calling a doctor "can this patient really take all these meds?" I remember one who took a Dalmane 30 mg, Mepergan x 2, Flexeril and Phenobarbital. Scared me to death. Hum Dalmane, that's been a while, I don't suppose it's around anymore? Maybe some LTC nurses would know?

sharann, BSN, RN · Oct 18, 2005

Dalmane is still around Dutchgirl, but is as old as the docs that perscribe it. Most are more up to date. When I had to be in the hosp overnight post op I needed a sleeper AND pain meds. Otherwise it was impossible to get any sleep in the hospital. The night shift tries but there is still nosie, IV pumps alarming,screamers etc... Let them sleep. You can always tell them that if you give them heavy doses, you will be around in 4 hours to check them and take vitals.

p.s" Its good you are asking these questions, shows you are a responsible nurse

HannasMom · Oct 18, 2005

We had a resident who had both, Vicodin 5/500 mg and ativan at a small dose together, scheduled. She also could have a Vicodin at night and if she felt anxious, she could have an Ativan an hour later. That's just how the MD prescribed it for her. Also if the resident is anxious, the Vicodin won't do much good, because how you are feeling mentally can effect how you feel physically.