Just for a quick reference:
Zoloft: excellent for anxiety treatment
Luvox: nothing spectacular. Good for OCD and SAD treatment.
Paxil: excellent for anxiety treatment. Weight gain is common.
Lexapro: GAD treatment. watch for initial anxiety.
Celexa: depression treatment. watch for initial anxiety.
Prozac: depression, OCD, anxiety, and eating disorder treatment. Very energizing.
GI side effects are the most common complaint. Watch for Serotonin Syndrome.
Saturday, October 30, 2010
Drug(s) for 10.30.10 - Zoloft and Luvox
Two drugs again today. We're pretty familiar with SSRIs by now, so let's finish this drug class and tomorrow we'll start something new. Any preferences? I'm thinking Atypical Antidepressants will be next...
Zoloft (Sertraline) is a SSRI labeled for use in PD, SAD, OCD, and PTSD. Off-label use is GAD, so basically, it's used for the same thing all SSRIs are used for. Definitely a pattern here.
Side effects of Zoloft are the same as all SSRIs, but GI upsets occur more frequently in patients who take this medication. Good news: Zoloft does not typically increase anxiety. Remember that some SSRIs have that affect? Zoloft is very effective for treating anxiety.
Luvox (Fluvoxamine Maleate) is our last SSRI! Again, same action as all other SSRIs (increases level of available serotonin) and same general side effects. Nothing too spectacular about this drug. It's primary purpose is treatment of OCD and SAD. but off-label uses are for treatment of GAD, PD, and PTSD. Just make sure you educate your patient, like always. Let them know the s&s of serotonin syndrome, and about all the other possible side effects.
THAT'S IT! SSRIs are done! If you've been following this daily, now would be a great time to review all the SSRIs. NOTE: I just went back and made a few adjustments on several side effects of this class. See if you can spot them. Nothing major, just a few additions.
Happy studying, and let's go Rangers!
SSRIs include Luvox, Lexapro, Celexa, Paxil, Prozac, and Zoloft. Write them down. Remember them!
Zoloft (Sertraline) is a SSRI labeled for use in PD, SAD, OCD, and PTSD. Off-label use is GAD, so basically, it's used for the same thing all SSRIs are used for. Definitely a pattern here.
Side effects of Zoloft are the same as all SSRIs, but GI upsets occur more frequently in patients who take this medication. Good news: Zoloft does not typically increase anxiety. Remember that some SSRIs have that affect? Zoloft is very effective for treating anxiety.
Luvox (Fluvoxamine Maleate) is our last SSRI! Again, same action as all other SSRIs (increases level of available serotonin) and same general side effects. Nothing too spectacular about this drug. It's primary purpose is treatment of OCD and SAD. but off-label uses are for treatment of GAD, PD, and PTSD. Just make sure you educate your patient, like always. Let them know the s&s of serotonin syndrome, and about all the other possible side effects.
THAT'S IT! SSRIs are done! If you've been following this daily, now would be a great time to review all the SSRIs. NOTE: I just went back and made a few adjustments on several side effects of this class. See if you can spot them. Nothing major, just a few additions.
Happy studying, and let's go Rangers!
SSRIs include Luvox, Lexapro, Celexa, Paxil, Prozac, and Zoloft. Write them down. Remember them!
Friday, October 29, 2010
Drug for 10.29.10 - Paxil
Paxil (Paroxetine) is today's drug! Keeping with the theme, yes, it is an SSRI. We already know that SSRIs are the drug of choice to treat depression, so Paxil can definitely be used in MDD and other depressive disorders. Remember that SSRIs can also treat anxiety? This is a good example! Paxil is used to treat panic disorder, social anxiety disorder (SAD), generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), and posttraumatic stress disorder (PTSD).
Side effects? We know these now. GI stuff, nausea, anorexia, sweating, headaches, poor concentration.... BTW, I forgot this! A side effect of ALL SSRIs is a significant decrease in libido. That's important patient teaching stuff. We know to watch for Serotonin Syndrome as well. That's an emergency!
Now, it seems like there every source I use gives slightly conflicting information on when to take each drug and such, possible because each patient will react a little different so there is no solid answer. But from what I've seen, it is said that Paxil should be taken in the morning. However, one source said it is very sedating, so I'd think you'd give it at night... I'll try to find out for sure.
Also, Paxil is definitely one of those SSRIs where weight gain is a common side effect. Encourage exercise and proper diet. :) This medication also interacts with many other medications; make sure you remind the patient taking Paxil to ask their doctor before they take ANY additional medications.
Hey! Paxil has 5 letters...it treats 5 anxiety disorders. Maybe that will help me remember it....?
Side effects? We know these now. GI stuff, nausea, anorexia, sweating, headaches, poor concentration.... BTW, I forgot this! A side effect of ALL SSRIs is a significant decrease in libido. That's important patient teaching stuff. We know to watch for Serotonin Syndrome as well. That's an emergency!
Now, it seems like there every source I use gives slightly conflicting information on when to take each drug and such, possible because each patient will react a little different so there is no solid answer. But from what I've seen, it is said that Paxil should be taken in the morning. However, one source said it is very sedating, so I'd think you'd give it at night... I'll try to find out for sure.
Also, Paxil is definitely one of those SSRIs where weight gain is a common side effect. Encourage exercise and proper diet. :) This medication also interacts with many other medications; make sure you remind the patient taking Paxil to ask their doctor before they take ANY additional medications.
Hey! Paxil has 5 letters...it treats 5 anxiety disorders. Maybe that will help me remember it....?
Thursday, October 28, 2010
Drug(s) for 10.28.10 - Lexapro and Celexa
Lexapro (escitalopram) and Celexa (citalopram) sound so alike. I know I will confuse them! Let's talk out the similarities and differences:
BOTH are SSRIs. Yeah, I am focusing on those this week! Remember how those work? They increase available levels of serotonin. That means Lexapro and Celexa are used to treat depression.
What else can SSRIs be used for? Anxiety disorders like GAD, PTSD, SAD, and for panic disorder.
Here's the difference:
Celexa is labeled for use in depression.
Lexapro's primary use is for Generalized Anxiety Disorder.
That's the main difference!! SO SIMPLE. They both have "off-label use" for PD, OCD, PTSD, and SAD.
Don't forget their side effects. We should really be learning this by now. SSRIs have a fairly rapid onset, and have side effects like agitation, insomnia, n/v, headache, and GI stuff. As always, don't give these with MAOIs and don't abruptly stop them. Withdrawal can occur. Encourage water intake throughout the day to avoid dry mouth, etc. Oh and remember...they take 1-4 weeks to truly have an effect. (and....SSRI patients always should be assessed for Serotonin Syndrome. That = emergency!!! and includes severe abdominal cramping, diarrhea, sweating, fever, elevated HR and BP, delerium, muscle spasms... even death. Oh dear.) Lexapro and Celexa have minimal interactions with other drugs. MAOIs are their major contraindication. Just remind the patient it is always a good idea to talk to their doctor before beginning any other medication.
**One interesting side effect is the possibility of initial anxiety. Inform the patient of this side effect, and encourage them to let the nurse or doctor know if the anxiety does not subside.
GO RANGERS!
BOTH are SSRIs. Yeah, I am focusing on those this week! Remember how those work? They increase available levels of serotonin. That means Lexapro and Celexa are used to treat depression.
What else can SSRIs be used for? Anxiety disorders like GAD, PTSD, SAD, and for panic disorder.
Here's the difference:
Celexa is labeled for use in depression.
Lexapro's primary use is for Generalized Anxiety Disorder.
That's the main difference!! SO SIMPLE. They both have "off-label use" for PD, OCD, PTSD, and SAD.
Don't forget their side effects. We should really be learning this by now. SSRIs have a fairly rapid onset, and have side effects like agitation, insomnia, n/v, headache, and GI stuff. As always, don't give these with MAOIs and don't abruptly stop them. Withdrawal can occur. Encourage water intake throughout the day to avoid dry mouth, etc. Oh and remember...they take 1-4 weeks to truly have an effect. (and....SSRI patients always should be assessed for Serotonin Syndrome. That = emergency!!! and includes severe abdominal cramping, diarrhea, sweating, fever, elevated HR and BP, delerium, muscle spasms... even death. Oh dear.) Lexapro and Celexa have minimal interactions with other drugs. MAOIs are their major contraindication. Just remind the patient it is always a good idea to talk to their doctor before beginning any other medication.
**One interesting side effect is the possibility of initial anxiety. Inform the patient of this side effect, and encourage them to let the nurse or doctor know if the anxiety does not subside.
GO RANGERS!
Wednesday, October 27, 2010
Drug for 10.27.10 - Prozac
Prozac (fluoxetine) is an SSRI, and is used to treat depression, OCD, eating disorders, and anxiety. SE are the same as that of other SSRIs (GI effects, fatigue...). With Prozac, the potential for seizures increases. If your patient is bulimic, monitor for binge eating and vomiting. Prozac can also increase your patient's anxiety...even though it can treat anxiety in a different patient. DON'T FORGET: it take 1-4 weeks to really work!
Interesting... It typically has a more activating, energizing effect than a sedating effect.
Post any additional info/corrections if you want!
Interesting... It typically has a more activating, energizing effect than a sedating effect.
Post any additional info/corrections if you want!
Week 1 Drug CLASS - SSRIs
I'll start off with SSRIs, aka Selective Serotonin Reuptake Inhibitors. They can be used for a variety of psych/mh needs. They are the first line drug for treating DEPRESSION (i.e. MDD, depression in bipolar) and can be used to treat anxiety, PTSD, and acute stress disorder.
SSRIs will take 1-4 weeks of daily usage to notice a real change in mood.
How do they work? They inhibit the reuptake of serotonin! Basically, they do not allow the reabsorbtion of serotonin to occur, so more serotonin is available and can be utilized. Hmmm...let's think: serotonin is the neurotransmitter involved with the regulation of sleep, with appetite and with libido. People with less that average/normal amounts of serotonin could present with: insomnia, hypersomnia (can't regulate sleep), recent weight gain or loss (a criteria for dx of depression...bingo!) because of change in appetite, and decreased sex drive (hmmm...anhedonia, anyone?). I GET IT. Increasing the level of serotonin helps even these symptoms out.
Ok, so how about SIDE EFFECTS? Not as many as with some other drugs, although there are still some. We should always assess for suicide, and this is no exception. Although some SSRIs don't necessarily increase suicide risk further than it already was, still monitor, especially in patients taking Celexa (citalopram). These can make you sleepy....or hyper. Give at bedtime or in the morning, depending on the drug. GUESS WHAT? Giving these meds at bedtime also helps with other side effects(GI stuff), because patients can sleep them off. Encourage them to drink water during the day.
SERIOUS SIDE EFFECT? Serotonin Syndrome = Abdominal pain, diarrhea, sweating, fever, elevated HR and BP, delerium, muscle spasms... even death. THIS IS BAD. THIS IS AN EMERGENCY.
NAMES? Just recognize these are SSRIs for now. I'll think of something clever later.
Lexapro
Luvox
Prozac
Paxil
Zoloft
Celexa
That's SSRIs. Study them. Know them. Love them.
SSRIs will take 1-4 weeks of daily usage to notice a real change in mood.
How do they work? They inhibit the reuptake of serotonin! Basically, they do not allow the reabsorbtion of serotonin to occur, so more serotonin is available and can be utilized. Hmmm...let's think: serotonin is the neurotransmitter involved with the regulation of sleep, with appetite and with libido. People with less that average/normal amounts of serotonin could present with: insomnia, hypersomnia (can't regulate sleep), recent weight gain or loss (a criteria for dx of depression...bingo!) because of change in appetite, and decreased sex drive (hmmm...anhedonia, anyone?). I GET IT. Increasing the level of serotonin helps even these symptoms out.
Ok, so how about SIDE EFFECTS? Not as many as with some other drugs, although there are still some. We should always assess for suicide, and this is no exception. Although some SSRIs don't necessarily increase suicide risk further than it already was, still monitor, especially in patients taking Celexa (citalopram). These can make you sleepy....or hyper. Give at bedtime or in the morning, depending on the drug. GUESS WHAT? Giving these meds at bedtime also helps with other side effects(GI stuff), because patients can sleep them off. Encourage them to drink water during the day.
SERIOUS SIDE EFFECT? Serotonin Syndrome = Abdominal pain, diarrhea, sweating, fever, elevated HR and BP, delerium, muscle spasms... even death. THIS IS BAD. THIS IS AN EMERGENCY.
NAMES? Just recognize these are SSRIs for now. I'll think of something clever later.
Lexapro
Luvox
Prozac
Paxil
Zoloft
Celexa
That's SSRIs. Study them. Know them. Love them.
Ok, psych... You are MINE.
Ok so it turns out Psychiatric nursing is a lot like English, and Med/Surg is a lot like math. Some people are really good at English, and some people are really good at math. Some people are really good at psych nursing, and some are really good at med/surg. Just like English and Math, you typically excel in one...and you despise the other. Don't get me wrong, I enjoy psychiatric nursing. I really do! I'm just no good at it. I'm not good in English classes either...
SO... to help me pass this class (which I like, I just suck at), I'm doing a drug of the day and a drug class of the week until school is over. Please comment any corrections or additions; I really DO want to learn this correctly!
Class of 2011... we will succeed!
SO... to help me pass this class (which I like, I just suck at), I'm doing a drug of the day and a drug class of the week until school is over. Please comment any corrections or additions; I really DO want to learn this correctly!
Class of 2011... we will succeed!
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