Question

Ms. Espinoza is a 90-year-old Hispanic woman admitted to the hospital from her assisted living facility. She has a history of hypertension and dementia and had a stroke and a myocardial infarction 3 years ago. She has also had insomnia for the past month. Ms. Espinoza is admitted due to an alteration in her mental status. She has had a cold and a cough for a week, for which she took Coricidin (acetaminophen and chlorpheniramine) and Tylenol PM (acetaminophen and diphenhydramine). Her home medications include monthly Nascobal (vitamin B12) injections; Toprol-XL (metoprolol succinate), 100 mg daily; Plendil (felodipine), 10 mg daily; Allegra (fexofenadine), 180 mg daily; Ecotrin (aspirin EC), 325 mg daily; and Colace (docusate sodium), 100 mg daily. She also has a very unsteady gait. Ms. Espinoza's admitting diagnosis is pneumonia. The physicians order the following medications: Lasix (furosemide), 20 mg IV push, x 1; Pepcid (famotidine), 20 mg bid; Ecotrin (aspirin EC), 325 mg daily; Toprol-XL (metoprolol succinate), 100 mg daily; Colace (docusate sodium), 100 mg daily; Allegra (fexofenadine), 180 mg daily; Levoquin (levofloxacin), 250 mg daily IVPB; Plendil (felodipine), 10 mg po daily; and Ambien (zolpidem), 5 mg at bedtime as needed.

1. Which medication(s) may have contributed to Ms. Espinoza's altered mental status?

Answer 1

1. Ambien (Zolpidem 5mg )at bed time ;

                      Zolpidem is a nonbenzodiazepine Z drug which acts as a sedative and hypnotic . Zolpidem is a type A GABA receptor agonist of the imidazopyridine class . it works by increasing GABA effects in the central nervous system by binding to GABA receptors at the same location as benzodiazepines . It generally has a half life of two to three hours. It also works to relax and calm people with a high level apprehension.