Medication Administration Tool (MAT)

Student Name: David Ngo ______ Date____________________________

Pt Initials: ____________ Allergies: __________________________________________________
Medication Order: Ambien (Zolpidem) Drug
Classification:__Imidazopyridine hypnotic___
RIGHT PATIENT MEDICATION INFORMATION
Why does the patient need Short term treatment of insomnia characterized by difficulties with
this medication? sleep initiation.
How does it relate to or help Inidazopyridine, a non-benzodiazepine hypnotic binds to GABA
with their diagnosis? receptor complex at the a-subunit/benzodiazepine receptor, the
major modulatory site.
RIGHT MEDICATION
How does this medication GABA receptor complex modulation is hypothesized to be
work? responsible for the sedative, anticonvulsant, anxiolytic,
myorelaxant properties.
Are there any assessments Pre-existing respiratory impairment, eg. myasthenia gravis, sleep
needed prior to or after apnea syndrome, COPD.
administering this
medication?
Allergies to this medication? No
Is this medication No
contraindicated for this
patient?
Patient teaching Take medication not with or right after meals. Inform about
completed/documented? benefits/risks with long-term use. Do not take with alcohol.
RIGHT TIME
Does this medication time No
need to be adjusted? (i.e.
meals, labs, etc.)
RIGHT DOSE
Is the prescribed dose safe Yes. Adult dose: 10mg qhs
(single and 24 hr. dose)?
Is the calculated dose Yes
correct?
Is there a therapeutic drug No
level that I should verify for
this medication prior to its
administration?
Are there adverse/toxic Drowsiness, dizziness, headache, nausea, diarrhea, dyspepsia,
effects? myalgia, lethargy, memory loss, anxiety, abnormal impairment
with alcohol and other CNS depressants.
What is the minimum safe N/A
dilution, infusion rate, and
compatibility for this
medication?
RIGHT ROUTE
Is it safe to administer this Yes.
medication via the
prescribed route?
Can this medication be Yes.
crushed or administered in Tablet.
another format better suited
for this patient?
If gastrointestinal tube, is N/A
placement verified?
Appropriate site for injection? N/A

MAT Rev: 5/18/2010