PSYCHOACTIVE MEDICATION CLASSIFICATION: __Selective Seratonin Reuptake Inhibitors___________________________________ Uses in Mental Health| |
Therapeutic Actions Expected to be Observed| Should relieve symptoms of major depressive disorder such as ability to once again find pleasure in relationships and daily activities, relief from hypersomnia or insomnia related to depression, restoration of appetite, lessened or relief from thoughts of suicide, and restored sex drive. Are sometimes prescribed to relieve some types of OCD or anxiety. | Common Side Effects of this Classification| Black Box Warning for increased suicidal thoughts and/or suicide. Common side effects include GI upset including nausea, vomiting and diarrhea. Also included are tinnitus, insomnia or sleep pattern changes, weight loss and/or gain typically variable within 7 pounds, fatigue and urinary retention. Can cause arrhythmias or EKG changes. One of the main adverse effects of SSRI’s that often affects adherence is the loss of sexual drive seen on the medications. | Nursing Interventions| Close and careful monitoring for suicidal thoughts or thoughts of hurting oneself or others is important to monitor as suicidal thoughts are a common side effect. Monitor for serotonin syndrome- excess serotonin and classified by hyperthermia, hypertension, rigidity, delirium, coma and myoclonus. | Patient/Family Teaching| Its extremely important that you notifty the patient before hand as well as family members (with consent) to notify their healthcare provider if the patient displays any signs of suicidal tendencies. It is good to teach patients that their medication may take up to 2-3 weeks to take full effect and to not discontinue their medications during this time because of lack of results. Similarly, while they are taking the medication they should not discontinue at any point because they “feel fine” as this can lead to sudden suicidal thoughts. | Trade Name| Lexapro| Celexa| Prozac| Paxil| Zoloft|
Generic Name| escitalopram| citilopram| fluoxetine| paroxetine| sertraline| Dosage| Adult: 10 mg/day AM or PMAfter 1 week, if no clinical effect noted, can be increased to 20 mg/day| 20 mg/day or 40 mg/day if not effective after 1 week| 20 mg/day may be increased to 20 mg/day BID after 4 weeks if no improvement is noted| 20 mg/day AM with a range of 20-50 mg/day or up to 60 mg/day in PTSD| 20-50 mg/day with a maximum of 200 mg/day. | Distinguishing/Critical Information| Black box suicide warning. Associated with QT interval elongation: monitor for heart problems| Black box suicide warning. Taking this medication with St. john’s wort may cause serotonin syndrome| Black box suicide warning. May experience withdrawal symptoms when stopping abruptly| Black box suicide warning. May have more significant weight gain. Have high risk for withdrawal symptoms.| Black box suicide warning. Was shown to have much higher fetal blood levels and may cause birth defects.| Skidmore-Roth, L. (2012). Mosb'ys 2012 nursing drug reference. St. Louis, Missouri: Elsevier. Varcarolis, E. (2011). Foundations of psychiatric mental health nursing. (6th ed.). St. Louis, Missouri: Elsevier.
To be completed individually as divided by clinical group. To be presented and shared in clinical conferences during first few weeks of clinical. Include references at bottom of page in APA format. Make copies of sheet(s) for Clinical Teacher. Sheets are to be kept, revised, and used as needed throughout clinical rotation.
Complete assignment in first clinical and submit to your clinical instructor.
Medication Presentation Assignment
I. Purpose: To facilitate understanding of psychotropic medications and their uses in psychiatric mental health nursing.
II. Description: Students will be assigned a...