Which of the following medications given to a 12-year-old client for the treatment of deep partial-thickness burn is the most important to double-check with another licensed nurse before administering it?
A. Aloe Vera Relief Burn spray.
B. Silver Sulfadiazine ointment.
C. Omeprazole 20 mg slow IV push.
D. Amitriptyline (Elavil) 50 mg PO.
Correct Answer: D. Amitriptyline (Elavil) 50 mg PO.
Amitriptyline (Elavil) is useful in the management of neuropathic pain following burn injury and since it is an antidepressant if given with a child, utmost precaution is given. The FDA has issued a black box warning regarding the use of amitriptyline in adolescents and young adults (ages less than 24 years). It can increase the risk of suicidal ideation and behavior.
Option A: Omeprazole is indicated for the short-term treatment of peptic ulcer disease in adults where most patients heal within four weeks. Patients with duodenal ulcer disease and H. pylori infection disease that is active for up to one year may benefit from combination therapy that includes omeprazole with clarithromycin, amoxicillin, and metronidazole.
Option B: Silver sulfadiazine is a medication used in the prevention, management, and treatment of burn wound infections. It is a heavy metal topical agent with antibacterial properties. Typically burn dressings consist of topical silver sulfadiazine combined with fine mesh gauze and are usable in both the inpatient and outpatient settings.
Option C: All health facilities practice double-checking of medications prior to administration, Of all the medications given, Amitriptyline is the most important to double-check with another licensed nurse.
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