DRUG STUDY

Mechanism of Side effects/ Nursing Monitoring

Brand: Therapeutic: Inhibits neuronal Major depressive use of MAO inhibitors CNS: SUICIDAL Do not confuse ● Assess for
antidepressants uptake of disorder. Panic or MAO-like drugs THOUGHTS, sertraline with suicidal tendencies,
Zoloft Pharmacologic: serotonin in the disorder. (linezolid or dizziness, cetirizine or Soriatane especially during
selective CNS, thus Obsessivecompuls methylene blue); drowsiness, fatigue, (acitretin). early therapy.
Generic: serotonin potentiating the ive Concurrent use of headache, ● Periodically reassess Restrict amount of
reuptake activity of disorder (OCD). pimozide; Oral insomnia, agitation, dose and continued drug available to
Sertraline inhibitors serotonin. Has Post-traumatic concentrate contains anxiety, confusion, need for patient. Risk may
(SSRIs) little effect on stress disorder alcohol; avoid in emotional lability, therapy. be increased in
norepinephrine (PTSD). Social patients with impaired ● PO: Administer as a children,
Dosage: or dopamine. anxiety disorder known intolerance. concentration, single dose in the adolescents,
Therapeutic (social phobia). Use Cautiously in: manic morning or and adults _24 yr.
Depression/O Effects: Premenstrual Severe hepatic or reaction, evening. After starting
CD Antidepressant dysphoric disorder renal impairment; nervousness, ● For oral concentrate, therapy, children,
PO (Adults): action. (PMDD). Patients with a history weakness, yawning. use dropper provided adolescents, and
50 mg/day as Decreased Unlabeled of mania; History of EENT: to remove young adults
a single dose incidence of Use: Generalized suicide pharyngitis, rhinitis, oral concentrate and should be seen
in the morning panic attacks. anxiety disorder attempt; Angle- tinnitus, visual mix with 4 oz (1/2 cup) by health care
or evening Decreased (GAD). closure glaucoma; abnormalities. CV: of water, ginger ale, professional at
initially; after obsessive and OB: Use during chest pain, lemon/lime soda, least weekly for 4
several wk compulsive third trimester may palpitations. GI: lemonade or wk,
may be behavior. result in neonatal diarrhea, dry mouth, orange juice ONLY. Do every 3 wk for next
increased at Decreased serotonin syndrome nausea, not mix with other 4 wk, and on advice
weekly feelings of requiring prolonged abdominal pain, liquids. of health
intervals up to intense fear, hospitalization, altered taste, Take immediately after care professional
200 mg/day, helplessness, or respiratory anorexia, mixing. Do not mix in thereafter.
depending on horror. and nutritional constipation, advance. ● Monitor appetite
response. Decreased support. Use only if dyspepsia, Slight haze may and nutritional
PO (Children social anxiety. potential benefit flatulence, increased appear after mixing; intake. Weigh
13–17 yr): Decrease in justifies potential risk appetite, vomiting. this is weekly. Notify
OCD—50 mg premenstrual to fetus; Lactation: GU: sexual normal. Dropper health care
once daily. dysphoria. May cause sedation dysfunction, dispenser contains dry professional of
PO (Children in infant; discontinue menstrual disorders, natural continued
6–12 yr): drug or bottle-feed; urinary disorders, rubber, advise patient weight loss. Adjust
OCD—25 mg Pedi: urinary frequency. with latex allergy. diet as tolerated to
once daily. May increase the risk Derm: increased Instruct patient to take support nutritional
 DRUG STUDY
Panic of suicide sweating, hot sertraline as directed. status.
Disorder attempt/ideation flashes, rash. Endo: Take ● Assess for
PO (Adults): especially during diabetes. F and E: missed doses as soon serotonin syndrome
25 mg/day early treatment or hyponatremia. as possible and return (mental changes
initially, may dose adjustment; risk MS: back pain, to regular [agitation,
increase after may be greater myalgia. Neuro: dosing schedule. Do hallucinations,
1 wk to in children or tremor, hypertonia, not double doses. Do coma], autonomic
50 mg/day. adolescents. hypoesthesia, not instability
PTSD paresthesia, stop abruptly; may [tachycardia, labile
PO (Adults): twitching. Misc: cause dysphoric mood, BP, hyperthermia],
25 mg once SEROTONIN irritability, neuromuscular
daily for 7 SYNDROME, fever, agitation, dizziness, aberrations [hyper-
days, then thirst. sensory disturbances reflexia,
increase to 50 (paresthesias incoordination],
mg once daily; such as electric shock and/or GI
may then be sensations), anxiety, symptoms [nausea,
increased if confusion, headache, vomiting, diarrhea]),
needed at lethargy, emotional especially in
intervals of at lability, insomnia, patients taking
least 7 days and hypomania. other serotonergic
(range 50–200 ● May cause drugs (SSRIs,
mg once drowsiness or SNRIs, triptans).
daily). dizziness. Caution ● Depression:
Social patient Monitor mood
Anxiety to avoid driving and changes. Inform
Disorder other activities health
PO (Adults): requiring alertness care professional if
25 mg once until response to the patient
daily initially, drug is known. demonstrates
then 50 mg ● Advise patient, significant
once daily; family, and caregivers increase in anxiety,
may be to look for suicidality, nervousness, or
increased at especially during early insomnia.
weekly therapy or dose ● Assess for
intervals up to changes. Notify health suicidal tendencies,
200 mg/ care professional especially during
day. immediately early therapy.
PMDD if thoughts about Restrict amount of
 DRUG STUDY
PO (Adults): suicide or dying, drug available to
50 mg/day attempts to commit patient.
initially either suicide; new or worse ● OCD: Assess
daily or daily depression or anxiety; patient for
during luteal agitation frequency of
phase of or restlessness; panic obsessive-
cycle. Daily attacks; insomnia; new compulsive
dosing may be or worse irritability, behaviors. Note
titrated aggressiveness, acting degree to which
upward in 50- on dangerous these
mg increments impulses, mania, or thoughts and
at the other changes in mood behaviors interfere
beginning of or behavior or if with daily
a cycle. In symptoms of serotonin functioning.
luteal phase– syndrome ● Panic Attacks:
only dosing a occur. Assess frequency
50 mg/day ● Advise patient to and severity of
titration avoid alcohol or other panic attacks.
step for 3 days CNS depressant ● PTSD: Assess
at the drugs during therapy patient for feelings
beginning of and to consult with of fear,
each luteal health helplessness,
phase dosing care professional and horror.
period should before taking other Determine effect on
be used medications social and
(range 50–150 and to avoid alcohol or occupational
mg/day). other CNS depressant functioning.
drugs ● Social Anxiety
Route: during therapy. Disorder: Assess
PO ● Instruct patient to patient for
notify health care symptoms
professional of of social anxiety
all Rx or OTC disorder (blushing,
medications, vitamins, sweating,
or herbal products trembling,
being taken and tachycardia during
consult health care interactions with
professional new
DRUG STUDY
before taking any new people, people in
medications, especially authority, or
St. John’s wort or groups) periodically
SAMe. during therapy.
● Inform patient that ● Premenstrual
frequent mouth rinses, Dysphoric
good oral Disorder: Assess
hygiene, and sugarless patient
gum or candy may for symptoms of
minimize premenstrual
dry mouth. If dry mouth dysphoric disorder
persists for more than (feeling angry,
2 wk, tense, or tired;
consult health care crying easily,
professional regarding feeling
use of saliva sad or hopeless;
substitute. arguing with family
● Advise patient to or friends
wear sunscreen and for no reason;
protective difficulty sleeping or
clothing to prevent paying attention;
photosensitivity feeling out of
reactions. control or unable to
● Advise patient to cope; having
notify health care cramping, bloating,
professional if food craving, or
headache, weakness, breast tenderness)
nausea, anorexia, periodically during
anxiety, or therapy.
insomnia persists. ● Lab Test
● Instruct female Considerations:
patient to inform health May cause false-
care professional positive
if pregnancy is planned urine screening
or suspected or if tests for
breast feeding. benzodiazepines.
● Emphasize the ● May cause
importance of follow-up hyperglycemia and
DRUG STUDY
exams to diabetes mellitus;
monitor progress. monitor serum
Encourage patient glucose if clinical
participation in symptoms occur.
psychotherapy to
improve coping skills.