INDEX NURS 2236 Clinical Form 3: Clinical Medications Worksheet

(You will need to made additional copies of these forms)

Generic Trade Classification Dose Route Time/Frequency
Name Name Antidepressant 20 Mg PO 1 in the AM
Fluoxetine Prozac Q AM

Peak Onset Duration Normal Dosage range

6-8 hours 20 Mg daily

Why is your patient taking this medication? For IV meds, compatability with IV drips and/or solutions
Depression

Mechanism of action and indications Nursing Implications (what to focus on)

Inhibits the CNS neuron uptoake of serotonin but not of
norepinephrine
Major depressive disorder, ovsessive-compulsive disorder
bulumia nervosa Sarafem: premenstrual dysphoric
Disorder
Interactions with other patient drugs, OTC, or herbal
medicines (ask patient specifically)
Do not use with thirodazine or within 5 weeks of DC
or Fluoxetine
Do not use MAOIs with or 14 days prior to fluoxetine
Do not use together, increased risk of serotonin syndrome:
St. John's wort, SAM-e
Contraindications/warnings/interactions
Assess mental status for mood, sensorium, affect, sucidial tendancies, increase in
psychiatric symptoms, depression, panic, monitor for seizures, monitor patients
blood pressure, weight every week- appetite
Common side effects headache, nervousness, insomnia, drowsiness, anxiety
tremor, dizziness, fatigue, sedation, poor concentration, abnormal dreams
agitation, seizures, apathy euphoria, hallucinations, delusions, psychosis, hot
flashes, palpitations, angina, hemorrhage, tachycardia, bradycardia, MI
thrombophlebitis,first degress AV block, Visual changes, ear/eye pain.
Lab value alterations caused by medicine
Increase: serum vilirubin, blood flucose, alk phosphatase
Decrease: VMA, 5 HIAA
False increase: urinary catecholamines
Be sure to teach the patient the following about this medication
Theraputic effect may take 1-4 weeks, to use caution in driving and other activity
that involves alertness due to drowsiness, use sunscreen due to photophobia.
avoid alcohol injestion and other CNS depressants, change position slowly,
orthostatic hypotention, avoid all OTC drugs unless approved

Nursing Process - Assessment Assessment Evaluation

(Pre-administration assessment
make sure there is not a drop in BP more than
20 mmHG, administer with food or milk, crush if
patient is unable to swallow, dosage at bed time
if oversedation during day time, gum, hard
candy, frequent sips of water for dry mouth,
Why would you hold or not give Check after giving
this med? dry mouth, GI upset, make sure patient gets
If there is a drop in blood pressure more than help with ambulation and moving (ortho-hypo)
20 mm Hg make sure patient has plenty of fluids