Pharmacological Classification Sheet_SNRIs/Pharmacological Classification Sheet_SNRIs. Verified By Gold Level Expert. Download To Score A

PHARMACOLOGICAL CLASSIFICATION SHEET Drug Guide Page #: Pearson Textbook Page #: Pharmacology For Nurses Pages #: Pharmacologic Classification: Selective serotonin and norepinephrine reuptake inhibitors - SSNRIs Generic Names (Trade Names): Desvenlafaxine (Pristiq); Duloxetine (Cymbalta); Venlafaxine (Effexor); Levomilnacipran (Fetzima) Prefix, Root, Suffix Therapeutic Classifications: antidepressants Indications: Major depressive disorder; generalized anxiety disorder; social anxiety disorder; panic disorder; diabetic peripheral neuropathic pain; fibromyalgia; chronic musculoskeletal pain Mechanism of Action: Inhibits neuronal reuptake of norepinephrine and serotonin in the CNS Therapeutic Effects: Decrease in depressive symptomatology, with fewer relapses/recurrences; decreased anxiety; decrease in panic attacks; decreased neuropathic pain; decreased symptoms of anxiety; decreased pain; Contraindications: hypersensitivity; children (safety not established); concomitant use with MAOIs; severe renal or hepatic impairment; pregnancy and lactation (safety not established); uncontrolled narrow-angle glaucoma Precautions (Use Cautiously): Hepatic and renal insufficiency; elderly and debilitated patients; patients with history of drug abuse; patients with suicidal ideation; patients with history of or existing cardiovascular disease; patients with history of mania; patients with history of seizures; children Adverse Reactions/ Side Effects: Headache; dry mouth; nausea; somnolence; dizziness; insomnia; asthenia; constipation; diarrhea; tachycardia; palpitations; activation of mania/hypomania; abnormal bleeding; hypertension; mydriasis; increased risk of suicidality in children and adolescents; discontinuation syndrome NURSING IMPLICATIONS Assessment: Assess mental status and mood changes, especially during initial few months of therapy and during dose changes; inform HCPif patient demonstrates significant increase in signs of depression; assess suicidal tendencies; monitor BP before and periodically during therapy; monitor appetite and nutritional intake; assess for serotonin syndrome; assess for sexual dysfunction; assess for rash periodically during therapy Drug / Food Interactions: Concomitant use of SNRIs with MAOIs results in serious, sometimes fatal, effects resembling neuroleptic malignant syndrome. Coadministration is contraindicated. • Serotonin syndrome may occur when SNRIs are used concomitantly with St. John’s wort, 5-HT1 receptor agonists (triptans), sibutramine, trazodone, or other drugs that increase levels of serotonin. • Increased effects of haloperidol, clozapine, and tricyclic antidepressants when used concomitantly with venlafaxine. • Increased effects of venlafaxine with cimetidine, terbinafine, and azole antifungals. • Decreased effects of venlafaxine with cyproheptadine. • Decreased effects of indinavir and metoprolol with venlafaxine. • Increased effects of warfarin and other drugs with anticoagulant effects with all SNRIs. • Lab Value Considerations May cause hyponatremia; may cause increase ALT, AST, bilirubin, CPK, and alkaline phosphatase; monitor blood sugar and hemoglobin A1c; may cause slight increase in blood glucose; Implementation (Administration Guidelines): Administer daily without regard to food; swallow ER capsules and tables whole; do not crush, break, or chew; ER capsules may be opened and contents sprinkled on a spoonful of applesauce; administer at the same time each day CF 18-2 This study source was downloaded by from CourseH on :49:50 GMT -05:00 This study resource was shared via Cour