Medication List for PTSD

Medication list for PTSD Mental Health Nursing Name: For each Medication please list: Name of Medication: Expected Pharmacologica l Action Therapeutic Use Complication s (Side Effects) Contraindicati ons/ Precautions Nursing Intervention s Patient Education Trazodone Trazodone is an antidepressant that belongs to a group of drugs called serotonin receptor antagonists and reuptake inhibitors (SARIs). Blocks serotonin reuptake along the presynaptic neuronal membrane, causing an antidepressant effect. Trazodone exerts an alphaadrenergic blocking action and produces modest histamine blockade, causing a sedative effect. To treat major depression. Psychosis, seizures, serotonin syndrome, somnolence, stupor, suicidal ideation, syncope, tardive dyskinesia, tremor, vertigo, Arrhythmias, congestive heart failure, hypotension, orthostatic, prolonged QT interval, vasodilation, CVA, Hemolytic anemia, leukocytosis, Apnea, dyspnea, Hyponatremi a. Hypersensitivit y to trazodone or its components, recovery from acute MI, use within 14days of an MAO inhibitor including intravenous methylene blue and linezolid. Use trazodone cautiously in patients with cardiac disease because drug can cause arrhythmias. Give trazodone shortly after the patient has a meal or light snack to reduce nausea. Give larger portion of daily dose at bedtime if drowsiness occurs. Be aware that serotonin syndrome in its most severe form may resemble neuroleptic malignant syndrome, which includes Urge patient to avoid taking trazodone on an empty stomach because doing so may increase the risk of dizziness or lightheadedness. Advise patient that drug may cause mild pupillary dilation, which may lead to an episode of acute closure glaucoma. Encourage patient to have an eye exam before starting therapy to see if he is at risk. Caution patient to avoid potentially hazardous activities during therapy until nervous system effects have abated. Caution patient not to take aspirin or nonsteroidal antiinflammatory agents without first discussing use with the prescriber. Instruct patient not It may help to improve your mood, appetite, and energy level as well as decrease anxiety and insomnia related to depression. Citalopram A Selective serotonin reuptake inhibitor (SSRI). Blocks serotonin reuptake by adrenergic nerves, which normally release this neurotransmitte r from their storage sites when activated by a nerve impulse. This blocked reuptake increases serotonin levels at nerve synapses, which may elevate mood and reduce depression. It is an antidepressant used to treat depression. CVA, neuroleptic malignant syndrome, paresthesia, seizures, serotonin syndrome, suicidal ideation, tremor heart failure, MI, prolonged QT interval, thrombosis, ventricular arrhythmias. Hypersensitivit y to citalopram or its components, pimozide therapy, use within 14 days of MAO inhibitor therapy including IV methylene blue or linezolid autonomic instability with possibly rapid changes in vital signs and mental status, and muscle rigidity. Stop drug immediately and provide supportive care. to stop trazodone therapy abruptly. Emphasize importance of notifying prescriber about unusual changes. Advise women of childbearing age to notify prescriber if pregnancy occurs or is suspected. It should also not be given to patients who are taking other drugs that prolong the QT interval. Inform patient that citalopram’s full effects may take up to 4 weeks. Advise patient not to self-medicate for allergies colds, or coughs without Expect consulting hypokalemia prescriber and because these hypomagnese preparations can mia to be increase the risk of corrected adverse reactions. before citalopram Caution patient not therapy is to stop citalopram begun. abruptly because doing so may lead Be aware that to serious adverse effective reactions. antidepressan t therapy may Urge caregivers to convert monitor patient depression closely for suicidal into mania in tendencies, predisposed especially when people. therapy starts or dosage changes. Assess elderly patients and Escitalopram Selective serotonin reuptake inhibitor (SSRI). Inhibits reuptake of the neurotransmitte r serotonin by CNS neurons, thereby increasing the amount of serotonin available in nerve synapses. An elevated serotonin level may result in elevated mood and reduced To treat major depression and treat generalized anxiety disorder Neuroleptic malignant syndrome, seizures, serotonin syndrome, suicidal ideation, Atrial fibrillation, cardiac failure, deep vein thrombosis, hypotension, MI, prolonged QT interval, torsades de pointes, Concomitant therapy with pimozide; hypersensitivit y to escitalopram, citalopram or its components; use within 14 days of MAO inhibitor therapy including intravenous methylene blue or linezolid those taking diuretics for signs suggesting syndrome of inappropriate secretion of antidiuretic hormone, including hyponatremia and increased serum and urine osmolality. Monitor patient closely for suicidal tendencies, especially when therapy starts or dosage changes, because depression may worsen at these times. Monitor patient for bleeding, especially if patient is also taking an anticoagulant , aspirin. Bleeding can range from ecchymoses, epistaxis, hematomas, and petechiae. Expect prescriber to reassess patient When discontinuing escitalopram, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. anxiety or depression. Desvenlafaxine Selective serotonin and norepinephrine reuptake inhibitor(SSNRI). Inhibits neuronal reuptake of norepinephrine and serotonin, along with its active metabolite, desmethylvenlaf axine. These actions raise norepinephrine and serotonin levels at nerve synapses, elevating mood and reducing depression. ventricular arrhythmias, Stevens– Johnson syndrome, toxic epidermal necrolysis To treat and prevent relapse of major depression. Bruxism, cerebral ischemia, neuroleptic malignant syndrome, seizures, serotonin syndrome, suicidal ideation, rrhythmias, AV block, congestive heart failure, extrasystoles, hypotension, MI, prolonged QT interval, thrombophle bitis, torsades de pointes, vasodilation, v-fib, PVD. Hypersensitivit y to desvenlafaxine, venlafaxine, or their components; use of an MAO inhibitor within 14 days, including intravenous methylene blue and linezolid periodically to determine the continued need for therapy and evaluate dosage. Know that if patient (particularly an adolescent) takes escitalopram for depression, she must be watched closely for suicidal tendencies Expect hypokalemia and hypomagnes emia to be corrected before drug therapy is begun. Monitor blood pressure often during therapy. Assess patient’s electrolyte balance, as ordered, because drug can cause hyponatremi a. Instruct patient not to chew or crush E.R. capsules or tablets. If she has trouble swallowing capsules, tell her to open capsule, sprinkle contents on a spoonful of applesauce, and swallow immediately without chewing, followed by a glass of water. Advise patient to avoid alcohol during therapy. Advise patient not to stop taking desvenlafaxine abruptly. Alert patient that fertility impairment may occur while Sertraline It is a selective serotonin reuptake inhibitor (SSRI). It inhibits reuptake of the neurotransmitte r serotonin by CNS neurons, thereby increasing the amount of serotonin available in nerve synapses. An elevated serotonin level may result in elevated mood and reduced depression. This action may also relieve symptoms of other psychiatric conditions attributed to serotonin deficiency and premenstrual dysphoric disorder. It is used to treat major depression. This therapeutic class is an antidepressant, antianxiety, antiobsessant, antipanic, antiposttraumati c stress, antipremenstrual dysphoric Seizure (convulsions) , blurred vision, tunnel vision, eye pain or swelling, racing thoughts, dryness of mouth, nosebleeds, overactive reflexes, racing heartbeat, red or purple spots on the skin, restlessness, shivering, skin rash, hives, or itching, increased energy, unusual risktaking behavior, extreme happiness, and being irritable or talkative, indigestion, loss of appetite, sweating, sleep problems (insomnia), decreased sex drive, impotence, and difÏculty having an Concurrent use of disulfiram (oral solution) or pimozide; hypersensitivit y to sertraline or its components; use within 14 days of an MAO inhibitor, including intravenous methylene blue and linezolid. Monitor liver enzymes and BUN and serum creatinine levels, as appropriate, in patients with hepatic or renal dysfunction. Monitor patient closely for evidence of GI bleeding, especially if patient takes a drug known to cause it, such as aspirin, an NSAID, or warfarin. When therapy stops, expect to taper dosage to minimize adverse not stop abprubtly. taking drug. Advise patient to have an eye exam before starting therapy to see if he is at risk of mild pupilary dilation. Inform patient that oral solution contains alcohol and should not be taken with disulfiram. Tell patient to take dose immediately after mixing it. Advise patient with a latex sensitivity to use an alternate dispenser because the supplied dropper dispenser contains dry natural rubber. Advise patient to avoid hazardous activities until drug’s CNS effects are known. Inform patient that use of certain drugs, such as aspirin, NSAIDs, other antiplatelet drugs, warfarin, or other anticoagulants, with sertraline may increase his risk for bleeding. orgasm. Venlafaxine Inhibits neuronal reuptake of norepinephrine and serotonin, along with its active metabolite, desmethylvenlaf axine. These actions raise norepinephrine and serotonin levels at nerve synapses, elevating mood and reducing depression. Prazosin Alpha blocker Antihypertensiv e. Selectively and competitively inhibits alpha1adrenergic receptors. This action To treat and prevent relapse of major depression cerebral ischemia, neuroleptic malignant syndrome, seizures, serotonin syndrome, suicidal ideation, rrhythmias, AV block, congestive heart failure, extrasystoles, hypotension, MI, prolonged QT interval, thrombophle bitis, Angioedema, hypersensitiv ity reactions. Hypersensitivit y to desvenlafaxine, venlafaxine, or their components; use of an MAO inhibitor within 14 days, including intravenous methylene blue and linezolid Used to manage hypertension Asthenia, Syncope, angina, bradycardia, edema, orthostatic hypotension, palpitations, Vasculitis. Dry mouth, eye pain. Gynecomasti a. Hypersensitivit y to prazosin, other quinazolines, or their components. They interact with Monitor patient closely for abnormal bleeding/he morrhage. Watch patient for suicidal tendencies, especially when therapy starts and dosage changes. Be aware that falsepositive urine immunoassa y screening tests for amphetamin e and phencyclidin e (PCP) have been found in patients taking desvenlafaxi ne or venlafaxine. Use prazosin cautiously in patients with renal impairment because of increased sensitivity to prazosin’s effects; in those with angina pectoris Instruct patient not to chew or crush E.R. capsules or tablets. If she has trouble swallowing capsules, tell her to open capsule, sprinkle contents on a spoonful of applesauce, and swallow immediately without chewing, followed by a glass of water. Advise patient to avoid alcohol during therapy. Advise patient not to stop taking desvenlafaxine abruptly. Alert patient that fertility impairment may occur while taking drug. Instruct patient who is starting prazosin to take drug at bedtime to minimize effects of first-dose hypotension. Emphasize need to take drug even if feeling well. Advise patient to avoid drinking alcohol, exercising promotes peripheral arterial and venous dilation and reduces peripheral vascular resistance, thereby lowering blood pressure. . Priapism, urinary incontinence. Hypersensitiv ity reactions (Increased risk of hypotension and syncope) because drug may induce or aggravate angina; in those with narcolepsy because prazosin may worsen cataplexy; and in elderly patients because they’re at increased risk for druginduced hypotension. Monitor blood pressure regularly to evaluate effectiveness of therapy. in hot weather, or standing for long periods because these activities increase risk of orthostatic hypotension. Suggest rising slowly from lying or sitÝng position to minimize orthostatic hypotension. Urge patient to avoid hazardous activities until drug’s CNS effects are known. Advise patient to notify prescriber immediately about adverse reactions, especially dizziness and fainting. Instruct patient not to take any drugs, including OTC forms, without consulting prescriber, to avoid serious interactions. Instruct male patient that a prolonged erection may occur with prazosin therapy.