A nurse is making rounds and performing physical assessments on each of the assigned patients. Which patient would the nurse most likely anticipate developing tachyphylaxis, so that she assesses for it specifically?
a. A patient who has been using opioids for pain relief
b. A patient who has been using opioids for recreational purposes
c. A patient who has been taking large doses of insulin for a long time
d. A patient who has been wearing a nitroglycerin patch for 24 hours
ANS: D
Tachyphylaxis is a form of tolerance that can be defined as a reduction in drug responsiveness brought on by repeated dosing over a short time. When nitroglycerin is administered by means of a transdermal patch, the effects are lost in less than 24 hours if the patch is left in place around the clock. This is why the nitroglycerin patch typically is ordered every 8 to 12 hours on and 8 to 12 hours off, to keep the body from building up tolerance (i.e., tachyphylaxis).
Opioids, whether used for pain relief or recreational purposes, do not cause tachyphylaxis.
Insulin, even when taken in large doses for extended periods, does not cause tachyphylaxis.
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