A client with a diagnosis of schizophrenia has stopped taking his prescribed olanzapine (Zyprexa) and gone on a cocaine and hallucinogen binge lasting several weeks
When providing care for this client in the acute care setting after a cocaine-induced myocardial infarction, the nurse should recognize what?
A) He cannot resume treatment with psychotropic medications until he has tested negative for recreational drugs twice consecutively.
B) The pharmacokinetics of his prescribed medications may be affected by his recent substance use.
C) His olanzapine dosage will be temporarily increased in order to compensate for his missed doses over the past weeks.
D) He will have his medications administered intramuscularly rather than orally for the duration of his hospital stay.
Ans: B
The impact of alcohol and drugs of abuse may alter pharmacokinetics and exacerbate adverse effects when psychotropic medication is administered. Dosages are never increased to compensate for the past. IM administration would only be necessary if the client is noncompliant and legally incompetent, and medication would not be withheld until the client has had two consecutive negative drug screens.
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