Pharm: Antidepressants Safety Issues

Question 1

Drug interactions

Answer 1

Nursing intervention:
instruct patient to inform their physician or nurse practitioner of all medications they are taking including herbal preparations and over-the-counter drugs

Question 2

Increased risk of suicide

Answer 2

Nursing intervention: assess frequently the presence or worsening of suicide ideations. initiate suicide precautions as needed. monitor patients use of medication as prescribed because these medications can be lethal and overdose

Question 3

Sedation

Answer 3

Nursing intervention: instruct patient not to drive or operate dangerous machinery when experiencing sedation

Question 4

Discontinuation syndrome.
SSRI: tremors, akthesia, Parkinson’s, dizziness, lethargy headache nausea.
TCA: hypomania, trimmers, akathisia, parkinson, cardiac arrhythmias, GI upset, panic attack
MAOI: myoclonic jerks, catatonic, flu-like symptoms confusion, hypomania

Answer 4

Nursing intervention instruct patients that all antidepressants have some potential for discontinuation syndrome and should not be stopped eruptly but rather should be tapered off. Paroxetine is associated with the highest risk of the continuation syndrome

Question 5

Photosensitivity

Answer 5

Nursing intervention instruct patient of vulnerability to severe sunburn and recommend sunscreen

Question 6

Orthostatic hypertension TCA

Answer 6

Instruct patient to rise slowly from sitting to standing. Monitor blood pressure and assess for symptoms

Question 7

Tachycardia, arrhythmias (TCA)

Answer 7

Nursing intervention monitor vital signs especially in elderly patients with pre-existing cardiovascular disorders

Question 8

Hyponatremia SSRI

Answer 8

Nursing intervention instruct patient to report any signs of nausea malaise lethargy muscle cramps. Assess for disorientation or restlessness. Monitor sodium levels

Question 9

Blurred vision while taking tca, ssri, and snri

Answer 9

Nursing intervention instruct patient to avoid driving and reassure patient that this side effect usually resolves within 3 weeks. Monitor blood pressure to rule out symptoms of hypertension