A patient is given a prescription for oxycodone/acetaminophen (Vicodin), two tablets to be taken every 4 to 6 hours as needed for pain. Which of the following statements should be included in the teaching?
a. "It is important to not to take this more often than prescribed because acetaminophen can cause dangerous side effects if taken more frequently."
b. "You shouldn't take this more than every 4 hours because oxycodone will cause respiratory depression."
c. "Oxycodone and acetaminophen interact to form a dangerous metabolite if they are taken less than 4 hours apart."
d. "Be careful not to take this more than every 4 hours because Vicodin always relieves pain for at least 4 hours."
ANS: A
Acetaminophen has a ceiling effect, so there is a dose beyond which there is no improvement in the analgesic effect, and there may be an increase in adverse effects. When used in combination with opioids, care must be taken to ensure that the dose of the nonopioid drug does not exceed the maximum safe dose for a 24-hour period. Respiratory depression occurs when doses of opioids are raised too quickly, not at specific doses or time intervals. Oxycodone does not form a dangerous metabolite when given with acetaminophen. No analgesic always relieves pain.
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