A nurse is reviewing the medication history of a client who is prescribed zolpidem (Ambien) for insomnia. The nurse should identify that which of the following medications can interact with zolpidem and increase its sedative effects?

Monitor oxygen saturation and end-tidal CO2 levels.This is because midazolam (Versed) is a benzodiazepine that can cause respiratory depression and sedation, especially when given intravenously. The nurse should monitor the client’s oxygenation and ventilation status during and after the procedure to prevent hypoxia and hypercapnia.

Choice A is wrong because naloxone (Narcan) is an opioid antagonist that reverses the effects of opioids, not benzodiazepines.Naloxone would not prevent respiratory depression caused by midazolam.

Choice C is wrong because giving midazolam with food or milk would not prevent respiratory depression.Food or milk may delay the absorption of oral midazolam, but it would not affect the intravenous administration.

Choice D is wrong because reducing the dose of midazolam by half may not be sufficient to prevent respiratory depression.The dose of midazolam should be individualized based on the client’s age, weight, health status, and response to the drug. Reducing the dose by half may also compromise the quality of sedation and analgesia during the colonoscopy.

Ketoconazole (Nizoral) can interact with zolpidem (Ambien) and increase its sedative effects.Ketoconazole is an antifungal medication that inhibits the metabolism of zolpidem, leading to higher plasma levels and increased risk of adverse effects such as drowsiness, dizziness, and impaired coordination.

Choice A is wrong because omeprazole (Prilosec) is a proton pump inhibitor that does not affect the metabolism or clearance of zolpidem.

Choice B is wrong because warfarin (Coumadin) is an anticoagulant that does not interact with zolpidem.However, warfarin levels may be affected by other medications or dietary factors that influence clotting.

Choice D is wrong because metformin (Glucophage) is an antidiabetic medication that does not interact with zolpidem.Metformin may cause gastrointestinal side effects such as nausea, diarrhea, and abdominal pain, but these are not related to zolpidem use.