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RN Nursing · Anticoagulant Medications · Practice question

Match each row with the correct column (Opioids, Ativan, Heparin, Alteplase).

Answer & explanation

Correct:

This question tests knowledge of antidote pairings for specific medications. Narcan (naloxone) is the reversal agent for opioids; it competitively displaces opioids from mu receptors, rapidly reversing respiratory depression and sedation. Romazicon (flumazenil) reverses benzodiazepines such as Ativan (lorazepam) by competitively blocking GABA-A receptor sites; it has a shorter half-life than most benzodiazepines so re-sedation monitoring is essential. Protamine sulfate neutralizes heparin through ionic bonding; its dose is calculated based on the amount of heparin given, and it is used in situations such as heparin overdose or at the end of cardiopulmonary bypass. Aminocaproic acid (Amicar) is an antifibrinolytic that counters the thrombolytic action of alteplase (tPA) by inhibiting plasminogen activators and plasmin, thereby halting fibrinolysis after thrombolytic therapy. Common errors include confusing protamine sulfate with vitamin K — vitamin K reverses warfarin, not heparin — and confusing aminocaproic acid with protamine. Remembering these pairings by mechanism helps: opioid antagonist reverses opioids, benzodiazepine antagonist reverses benzodiazepines, a positively charged protein reverses the negatively charged heparin, and an antifibrinolytic reverses clot-dissolving therapy.

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