A nurse is reviewing the medication regimen of a 65-year-old patient with multiple comorbidities. The patient's current medications include: Metoprolol 50 mg PO BID for Hypertension Triazolam 0.25 mg PO at Bedtime for Insomnia Sertraline 50 mg PO q24hr for Depression Oxycodone 5 mg PO q6hr PRN for Pain Which of the following statements about this medication regimen are correct? (Select All that Apply.)
Explanation & Rationale
A. Beta-blockers like metoprolol can mask the signs of hypoglycemia: Metoprolol can blunt adrenergic symptoms such as tachycardia and tremors, which are key warning signs of hypoglycemia. This is especially concerning in diabetic patients who rely on these symptoms for early detection of low blood glucose. B. It is safe to take additional doses of Sertraline if the patient feels like their symptoms are worsening: Sertraline, a selective serotonin reuptake inhibitor (SSRI), must be taken exactly as prescribed. Taking extra doses increases the risk of serotonin syndrome, which can be life-threatening and requires medical supervision for dosage adjustments. C. The patient should be monitored for orthostatic hypotension: Older adults taking medications like metoprolol and triazolam are at increased risk for orthostatic hypotension due to vasodilation and CNS depression. Monitoring helps prevent falls and syncope, especially when changing positions. D. Oxycodone can be used long-term without risk of physical dependence: Oxycodone is an opioid analgesic and carries a high risk of tolerance, physical dependence, and addiction when used long-term. Even when used appropriately, patients can develop dependence, necessitating careful monitoring. E. The combination of triazolam and oxycodone increases the risk of respiratory depression: Both drugs are CNS depressants, and their combination can have a synergistic effect on respiratory centers in the brain. This raises the risk of severe respiratory depression, particularly in older adults or those with underlying respiratory conditions.