Cebu Normal University

College of Nursing
PSYCHOTROPIC DRUG STUDY IN
PSYCHIATRY AS A NURSING SPECIALTY
DRUG DATA CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS SIDE EFFECT/
ADVERSE
REACTIONS
NURSING RESPONSIBILITIES
GENERIC NAME:
Fluoxetine HCl
TRADE NAME:
Proz!" Proz! #ee$l%"
Sr&e'
PATIENTS DOSE:
MINIMUM DOSE:
() '*/+%
MAXIMUM DOSE:
,) '*/+%
CONTENTS:
Fluoxetine -N.'et/%l.
0.1/en%l.0.23.
-tri&luoro'et/%l41/enox
%51ro1n.(.'ine4
H%+ro!/lori+e
AVAILABILITY &
PHARMACOLOGIC:
Sele!ti6e Serotonin
Reu1t$e In/i7itor
-SSRI84
THERAPEUTIC:
Anti+e1re88nt
PREGNANCY
CATEGORY:
C
PHARMACOKINETICS:
A: #ell 78or7e+ &ter orl
+'ini8trtion
D: Cro88e8 7loo+.7rin
7rrier
M&E: Con6erte+ 7% t/e li6er
to nor&luoxetine -1ri'ril% 7%
C9P:D, i8o.enz%'e4;
not/er nti+e1re88nt
!o'1oun+" 'o8tl%
'et7olize+ 7% t/e li6er" (:<
ex!rete+ 7% $i+ne%8 8
un!/n*e+ ; =< 8
un!/n*e+>
Half-life: (.0 +%8
P!"ei# $i#%i#&: ?3>@<
ROUTE: PO
ONSET: (.3 Aee$8
PEAK: un$noAn
DURATION: : Aee$8
THERAPEUTIC LEVELS:
@)B3C) n*/'L
GENERAL
INDICATIONS:
MDor +e1re88i6e
+i8or+er> O78e88i6e
!o'1ul8i6e +i8or+er>
Buli'i ner6o8>
Pni! +i8or+er;
De1re88i6e e1i8o+e8
88o!ite+ Ait/
7i1olr I +i8or+er
-A/en u8e+ Ait/
olnz1ine4"
tret'ent.re8i8tnt
+e1re88ion -Ait/
olnz1ine4
PATIENTS
ACTUAL
INDICATIONS:
CONTRAINDICA-
TIONS:
H%1er8en8iti6it%;
!on!urrent u8e or u8e
Ait/in (3 +%8 o&
+i8!ontinuin* MAO
in/i7itor8" !on!urrent u8e
o& 1i'ozi+e; !on!urrent
u8e o& t/iori+zine
-8/oul+ 7e +i8!ontinue+
t le8t @ Aee$8 7e&ore
t/er1% initite+; &or ll
!ontrin+i!te+ +ru*84
PRECAUTIONS:
Se6ere /e1ti!/renl
i'1ir'ent -loAer/le88
&reEuent +o8e '% 7e
ne!e88r%4; 8eizure
/i8tor%; +e7ilitte+
1tient8; +i7ete8
'ellitu8; 1tient8 Ait/
!on!urrent !/roni!
illne88
DRUG
INTERACTIONS:
DRUG TO DRUG
CNSF He+!/e;
ner6ou8ne88;
in8o'ni;
+roA8ine88;
nxiet%; tre'or;
+izzine88; li*/t.
/e+e+ne88;
*ittion;
8e+tion;
7nor'l *it;
8eizure8
CVF Hot &l8/e8;
1l1ittion8
Der'tolo*i!F
SAetin*; r8/;
1ruritu8; !ne;
lo1e!i; !ont!t
+er'titi8
GIF Nu8e;
6o'itin*;
+irr/e; +r%
'out/; norexi;
+%81e18i;
!on8ti1tion;
t8te !/n*e8;
&ltulen!e;
*8troenteriti8;
+%81/*i;
*in*i6iti8
BE'ORE:
(> Re+ ti!$et; !o'1re Ait/ +o!torG8
or+er n+ /6e 8i*ne+ 7% /e+ nur8e>
:> Hi8tor%F H%1er8en8iti6it% to
&luoxetine; i'1ire+ /e1ti! or renl
&un!tion; +i7ete8 'ellitu8; l!ttion;
1re*nn!%; 8eizure8
0> P/%8i!lF #ei*/t; 8$in r8/; le8ion8"
re&lexe8; &&e!t" 7oAel 8oun+8; li6er
e6lution; 1eri1/erl 1er&u8ion"
urinr% out1ut; LFT8; renl &un!tion
te8t8
3> Me+i!l /n+A8/in* 8/oul+ 7e
+one 1rior to 1tient /n+lin* n+ +ru*
+'ini8trtion>
@> T$e 78eline 6itl 8i*n8> -TPRBP;
Pin 8!ore i& 11li!7le4
DURING:
(> Greet 1t> n+ SO; 6eri&% !lient
i+entit% -6er7l; 1t> t*8; 7e+ nu'7er4>
A88e88 78eline 6/8>
:> Arrn*e &or loAer or le88 &reEuent
+o8e8 in el+erl% 1tient8 n+ 1tient8
Ait/ /e1ti! or renl i'1ir'ent>
0> BLACK BOX (ARNINGF
E8t7li8/ 8ui!i+e 1re!ution8 &or
8e6erel% +e1re88e+ 1tient8> Li'it
Euntit% o& !18ule8 +i81en8e+" /i*/
ri8$ in !/il+ren n+ +ole8!ent8>
COLOR:
T7let8H(); :) '*
C18ule8H(); :); 3)
'*
LiEui+H:) '*/@ Ml
DR !18ule8H?) '*
ROUTE)S O'
ADMINISTRATION:
1o
#ARNINGF
Po88i7le &tl
re!tion8 Ait/
MAOI8" +o not
+'ini8ter to*et/er"
:.A$ A8/out 1erio+
nee+e+>
In!re8e+
t/er1euti! n+ toxi!
e&&e!t8 o& TCA8> Do
not u8e Ait/
t/iori+zine
-in!re8e+ le6el8 o&
t/iori+zine4
De!re8e+
e&&e!ti6ene88 i& t$en
A/ile 8'o$in*
In!re8e+ toxi!it% o&
lit/iu'" 6oi+ t/i8
!o'7intion
A++iti6e CNS
e&&e!t8 i& !o'7ine+
Ait/
7enzo+ize1ine8;
l!o/ol" 6oi+ t/e8e
!o'7intion8
A6oi+
+'ini8trtion Ait/
ot/er 8erotoner*i!
+ru*8" '% le+ to
8erotonin 8%n+ro'e
FOOD TO DRUG
In!re8e+ ri8$ o&
8erotonin 8%n+ro'e
Ait/ St> Io/nG8 Aort
n+ SAMe>
GUF Pin&ul
'en8trution;
8exul
+%8&un!tion;
&reEuen!%;
!%8titi8;
i'1oten!e;
ur*en!%;
6*initi8
Re81irtor%F
URI8;
1/r%n*iti8;
!ou*/; +%81ne;
7ron!/iti8;
r/initi8
Ot/erF Aei*/t
!/n*e8;
8t/eni; &e6er
3> A+'ini8ter +ru* in t/e 'ornin*>
@> Monitor 1tient &or re81on8e to
t/er1% &or u1 to 3 A$ 7e&ore
in!re8in* +o8e>
,> SAit!/ to on!e Aee$ t/er1% 7%
8trtin* Aee$l% +o8e = +%8 &ter l8t :)
'*/+% +o8e> I& re81on8e i8 not
8ti8&!tor%; re!on8i+er +il% +o8in*>
A'TER:
(> Monitor 'oo+ !/n*e8> Let SO
in&or' nur8e i& 1t> +e'on8trte8
8i*ni&i!nt in!re8e in nxiet%;
ner6ou8ne88 or in8o'ni>
:> A88e88 &or n% 8exul 8i+e e&&e!t8
&ter +'ini8trtion -ere!tile
+%8&un!tion; +e!re8e+ li7i+o4
0> A88e88 &or 8en8iti6it% re!tion8 &ter
+'ini8trtion>
3> DOCUMENT /our; 'ount;
'e+i!tion n+ +ru* re!tion -i& n%4
@> Monitor 11etite n+ nutritionl
int$e> #ei*/ Aee$l%; note !ontinue+
Aei*/t lo88> A+Du8t +iet 8 tolerte+ to
8u11ort nutritionl 8ttu8>
,> Continull% o78er6e 1t> re81on8e to
+ru* t/er1% -6/8; l7 ex'84 n+
8erotonin 8%n+ro'e
Sour!eF De*lin; I> H>;
J Vllern+; A> H>
-:)((4> D6i8K8 +ru*
*ui+e &or nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11 @?=.
,))4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i;
PennF F>A> D6i8> -11
@?=.,))4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or nur8e8>
P/il+el1/i; PennF F>A>
D6i8> -11 @?=.,))4
Sour!eF De*lin; I>
H>; J Vllern+; A>
H> -:)((4> D6i8K8
+ru* *ui+e &or
nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11
@?=.,))4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i;
PennF F>A> D6i8> -11
@?=.,))4
/tt1F//nur8e8l78>!o'/&lu
oxentine./!l/
Sour!eF
De*lin; I> H>;
J Vllern+;
A> H> -:)((4>
D6i8K8 +ru*
*ui+e &or
nur8e8>
P/il+el1/i;
PennF F>A>
D6i8> -11 @?=.
,))4
Sour!eF De*lin; I> H>; J Vllern+;
A> H> -:)((4> D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i; PennF F>A>
D6i8> -11 @?=.,))4
/tt1F//nur8e8l78>!o'/&luoxentine./!l/
DRUG DATA CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS SIDE EFFECT/
ADVERSE
REACTIONS
NURSING RESPONSIBILITIES
GENERIC NAME:
Duloxetine
TRADE NAME:
C%'7lt
PATIENTS DOSE:
MINIMUM DOSE:
:) '*/+%
MAXIMUM DOSE:
,) '*/+%
CONTENTS:
Duloxetine -N.Met/%l.
0.-n1/t/len.(.%lox%4.
0.-t/io1/en.:.
%l41ro1n.(.'ine4
PHARMACOLOGIC:
Sele!ti6e Serotonin
Reu1t$e In/i7itor
-SSRI84
THERAPEUTIC:
Anti+e1re88nt
PREGNANCY
CATEGORY:
C
PHARMACOKINETICS:
A: #ell 78or7e+ &ter orl
+'ini8trtion
D: Un$noAn
M&E: Mo8tl% 'et7olize+
1ri'ril% 7% C9P:D, n+
C9P(A: enz%'e 1t/A%8
Half-life: (: Hi*/l% -L?)<4
1rotein 7oun+
ROUTE: PO
ONSET: un$noAn
PEAK: , /our8
DURATION: *: /our8
THERAPEUTIC LEVELS:
:).C) n*/'L
GENERAL
INDICATIONS:
MDor +e1re88i6e
+i8or+er> Di7eti!
1eri1/erl
neuro1t/i! 1in>
Generlize+ nxiet%
+i8or+er>
Fi7ro'%l*i>
-Unl7ele+F Stre88;
urinr%
in!ontinen!e4
PATIENTS
ACTUAL
INDICATIONS:
CONTRAINDICA-
TIONS:
H%1er8en8iti6it%;
!on!urrent u8e o& MAO
in/i7itor8" un!ontrolle+
n*le.!lo8ure *lu!o';
en+.8t*e renl +i8e8e"
!/roni! /e1ti!
i'1ir'ent or 8u78tntil
l!o/ol u8e -in!re8e+
/e1titi8 ri8$4; l!ttion
PRECAUTIONS:
Hi8tor% o& 8ui!i+e
tte'1t or i+etion;
'ni /i8tor%; !on!urrent
u8e o& ot/er !entrll%
!tin* +ru*8 A/i!/ '%
in!re8e +6er8e
re!tion8 ri8$; 8eizure
+i8or+er /i8tor%;
!ontrolle+ n*le.!lo8ure
*lu!o'; +i7eti!
1tient8 n+ t/o8e Ait/
renl i'1ir'ent
CNSF Neurole1ti!
'li*nnt
8%n+ro'e;
8eizure8; 8ui!i+e
t/ou*/t8; &ti*ue;
+roA8ine88;
in8o'ni; 'ni
!ti6tion;
+izzine88;
ni*/t're8
EENTF Blurre+
6i8ion; in!re8e+
IOP
CVF H%1erten8ion
GIF
He1totoxi!it%;
+e!re8e+
11etite;
!on8ti1tion; +r%
'out/; nu8e;
+irr/e; *8triti8;
6o'itin*
FJEF
H%1ontre'i
GUF D%8uri;
7nor'l or*8';
BE'ORE:
(> Re+ ti!$et; !o'1re Ait/ +o!torG8
or+er n+ /6e 8i*ne+ 7% /e+ nur8e>
:> Hi8tor%F H%1er8en8iti6it% to
&luoxetine; i'1ire+ /e1ti! or renl
&un!tion; +i7ete8 'ellitu8; l!ttion;
1re*nn!%; 8eizure8
0> P/%8i!lF #ei*/t; 8$in r8/; le8ion8"
re&lexe8; &&e!t" 7oAel 8oun+8; li6er
e6lution; 1eri1/erl 1er&u8ion"
urinr% out1ut; LFT8; renl &un!tion
te8t8
3> Me+i!l /n+A8/in* 8/oul+ 7e
+one 1rior to 1tient /n+lin* n+
+ru* +'ini8trtion>
@> T$e 78eline 6itl 8i*n8> -TPRBP;
Pin 8!ore i& 11li!7le4
DURING:
(> Greet 1t> n+ SO; 6eri&% !lient
i+entit% -6er7l; 1t> t*8; 7e+ nu'7er4>
A88e88 78eline 6/8>
:> M% 7e +'ini8tere+ Ait/out re*r+
to 'el8> Do not !/eA; !ru8/ or o1en
n+ 81rin$le !ontent8 on &oo+ or
liEui+8>
AVAILABILITY &
COLOR:
C18ule8F :); 0); ,) '*
-7lue n+ %elloA
!olore+4
ROUTE)S O'
ADMINISTRATION:
1o
DRUG
INTERACTIONS:
DRUG TO DRUG
Con!urrent u8e Ait/
MAO in/i7itor8 '%
re8ult in 8eriou8
1otentill% &tl
re!tion8>
Linezoli+; tr'+ol
n+ tri1tn8 in!re8e
ri8$ o& 8erotonin
8%n+ro'e
Flu6ox'ine n+
&luoroEuinolone8
in!re8e 8eru'
le6el8; 8/oul+ not 7e
t$en to*et/er
In!re8e+ ri8$ o&
7lee+in* Ait/
81irin8; NSAID8 or
Ar&rin
A6oi+ +'ini8trtion
Ait/ ot/er
8erotoner*i! +ru*8"
'% le+ to
8erotonin 8%n+ro'e
FOOD TO DRUG
In!re8e+ ri8$ o&
8erotonin 8%n+ro'e
Ait/ St> Io/nG8 Aort
n+ SAMe>
ED; De!re8e+
li7i+o; urinr%
retention
Der'F
Di1/ore8i8;
1ruritu8; r8/
NeuroF tre'or8
Mi8!>F
SEROTONIN
S9NDROME
0> BLACK BOX (ARNINGF
E8t7li8/ 8ui!i+e 1re!ution8 &or
8e6erel% +e1re88e+ 1tient8> Li'it
Euntit% o& !18ule8 +i81en8e+" /i*/
ri8$ in !/il+ren n+ +ole8!ent8>
3> A+'ini8ter +ru* in t/e 'ornin*>
@> Monitor 1tient &or re81on8e to
t/er1% &or u1 to 3 A$8 7e&ore
in!re8in* +o8e>
,> In8tru!t SO8 to in&or' nur8e &or n%
8i*n8 o& n1/%lxi8 or +6er8e +ru*
e&&e!t8>
A'TER:
(> A88e88 'entl 8ttu8> Let SO in&or'
nur8e i& 1t> +e'on8trte8 8i*ni&i!nt
in!re8e in nxiet%; ner6ou8ne88 or
in8o'ni>
:> A88e88 &or n% 8exul 8i+e e&&e!t8
&ter +'ini8trtion -ere!tile
+%8&un!tion; +e!re8e+ li7i+o4
0> A88e88 &or 8en8iti6it% re!tion8 &ter
+'ini8trtion>
3> DOCUMENT /our; 'ount;
'e+i!tion n+ +ru* re!tion -i& n%4
@> Monitor 11etite n+ nutritionl
int$e> #ei*/ Aee$l%; note !ontinue+
Aei*/t lo88> A+Du8t +iet 8 tolerte+ to
8u11ort nutritionl 8ttu8>
,> Continull% o78er6e 1t> re81on8e to
+ru* t/er1% -6/8; l7 ex'84 n+
8erotonin 8%n+ro'e
Sour!eF De*lin; I> H>;
J Vllern+; A> H>
-:)((4> D6i8K8 +ru*
*ui+e &or nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11 3?).
3?:4
Sour!eF De*lin; I> H>;
J Vllern+; A> H>
-:)((4> D6i8K8 +ru*
*ui+e &or nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11 3?).
3?:4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i; PennF
F>A> D6i8> -11 3?).3?:4
/tt1F//re&eren!e>'e+8!1e>!o
'/+ru*/!%'7lt.+uloxetine.
03:?,)
Sour!eF De*lin; I>
H>; J Vllern+; A>
H> -:)((4> D6i8K8
+ru* *ui+e &or
nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11
3?).3?:4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i;
PennF F>A> D6i8> -11
3?).3?:4
Sour!eF De*lin;
I> H>; J
Vllern+; A> H>
-:)((4> D6i8K8
+ru* *ui+e &or
nur8e8>
P/il+el1/i;
PennF F>A>
D6i8> -11 3?).
3?:4
Sour!eF De*lin; I> H>; J Vllern+;
A> H> -:)((4> D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i; PennF F>A>
D6i8> -11 3?).3?:4
/tt1F//re&eren!e>'e+8!1e>!o'/+ru*/
!%'7lt.+uloxetine.03:?,)
DRUG DATA CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTRAINDICATIONS SIDE EFFECT/
ADVERSE
REACTIONS
NURSING RESPONSIBILITIES
GENERIC NAME:
Sertrline
TRADE NAME:
Molo&t
PATIENTS DOSE:
MINIMUM DOSE:
:@ '*/+%
MAXIMUM DOSE:
:)) '*/+%
CONTENTS:
Sertrline --(S;3S4.3.
-0;3.+i!/loro1/en%l4.N.
'et/%l.(;:;0;3.
tetr/%+ron1/t/len.(.
'ine4
PHARMACOLOGIC:
Sele!ti6e Serotonin
Reu1t$e In/i7itor
-SSRI84
THERAPEUTIC:
Anti+e1re88nt
PREGNANCY
CATEGORY:
C
PHARMACOKINETICS:
A: A11er8 to 7e Aell
78or7e+ &ter orl
+'ini8trtion
D: Exten8i6el% +i8tri7ute+
t/rou*/out 7o+% ti88ue8
M&E: Exten8i6el%
'et7olize+ 7% t/e li6er; one
'et7olite /8 8o'e nti.
+e1re88nt !ti6it%" (3<
ex!rete+ un!/n*e+ in &e!e8
Half-life: :3 /our8
ROUTE: PO
ONSET: Ait/in :.3 Aee$8
PEAK: un$noAn
DURATION: un$noAn
THERAPEUTIC LEVELS:
?>@ to @, n*/'l
GENERAL
INDICATIONS:
MDor +e1re88i6e
+i8or+er> Pni!
+i8or+er> O78e88i6e
!o'1ul8i6e +i8or+er>
Po8t.tru'ti! 8tre88
+i8or+er> So!il
nxiet% +i8or+er>
Pre'en8trul
+%81/ori! +i8or+er>
Unl7ele+F Generl
nxiet% +i8or+er>
PATIENTS
ACTUAL
INDICATIONS:
CONTRAINDICA-
TIONS:
H%1er8en8iti6it%;
!on!urrent u8e o& MAO
in/i7itor8" un!ontrolle+
n*le.!lo8ure *lu!o';
en+.8t*e renl +i8e8e"
!/roni! /e1ti!
i'1ir'ent or 8u78tntil
l!o/ol u8e -in!re8e+
/e1titi8 ri8$4; l!ttion
PRECAUTIONS:
Hi8tor% o& 8ui!i+e
tte'1t or i+etion;
'ni /i8tor%; !on!urrent
u8e o& ot/er !entrll%
!tin* +ru*8 A/i!/ '%
in!re8e +6er8e
re!tion8 ri8$; 8eizure
+i8or+er /i8tor%;
!ontrolle+ n*le.!lo8ure
*lu!o'; +i7eti!
1tient8 n+ t/o8e Ait/
renl i'1ir'ent
DRUG
CNSF Neurole1ti!
'li*nnt
8%n+ro'e;
8eizure8; 8ui!i+e
t/ou*/t8; &ti*ue;
+roA8ine88;
in8o'ni; 'ni
!ti6tion;
+izzine88;
ni*/t're8
EENTF Blurre+
6i8ion; in!re8e+
IOP
CVF H%1erten8ion
GIF
He1totoxi!it%;
+e!re8e+
11etite;
!on8ti1tion; +r%
'out/; nu8e;
+irr/e; *8triti8;
6o'itin*
FJEF
H%1ontre'i
GUF D%8uri;
7nor'l or*8';
ED; De!re8e+
BE'ORE:
(> Re+ ti!$et; !o'1re Ait/ +o!torG8
or+er n+ /6e 8i*ne+ 7% /e+ nur8e>
:> Hi8tor%F H%1er8en8iti6it% to
&luoxetine; i'1ire+ /e1ti! or renl
&un!tion; +i7ete8 'ellitu8; l!ttion;
1re*nn!%; 8eizure8
0> P/%8i!lF #ei*/t; 8$in r8/; le8ion8"
re&lexe8; &&e!t" 7oAel 8oun+8; li6er
e6lution; 1eri1/erl 1er&u8ion"
urinr% out1ut; LFT8; renl &un!tion
te8t8
3> Me+i!l /n+A8/in* 8/oul+ 7e
+one 1rior to 1tient /n+lin* n+
+ru* +'ini8trtion>
@> T$e 78eline 6itl 8i*n8> -TPRBP;
Pin 8!ore i& 11li!7le4
DURING:
(> Greet 1t> n+ SO; 6eri&% !lient
i+entit% -6er7l; 1t> t*8; 7e+ nu'7er4>
A88e88 78eline 6/8>
:> M% 7e +'ini8tere+ Ait/out re*r+
to 'el8> Do not !/eA; !ru8/ or o1en
n+ 81rin$le !ontent8 on &oo+ or
liEui+8>
0> BLACK BOX (ARNINGF
AVAILABILITY &
COLOR:
T7let8F :@; @); ()) '*
C18ule8F @); ()) '*
Orl !on!entrteF :)
'*/'L in ,) 'L
7ottle8
ROUTE)S O'
ADMINISTRATION:
1o
INTERACTIONS:
DRUG TO DRUG
Con!urrent u8e Ait/
MAO in/i7itor8 '%
re8ult in 8eriou8
1otentill% &tl
re!tion8>
Linezoli+; tr'+ol
n+ tri1tn8 in!re8e
ri8$ o& 8erotonin
8%n+ro'e
Flu6ox'ine n+
&luoroEuinolone8
in!re8e 8eru'
le6el8; 8/oul+ not 7e
t$en to*et/er
In!re8e+ ri8$ o&
7lee+in* Ait/
81irin8; NSAID8 or
Ar&rin
A6oi+ +'ini8trtion
Ait/ ot/er
8erotoner*i! +ru*8"
'% le+ to
8erotonin 8%n+ro'e
FOOD TO DRUG
In!re8e+ ri8$ o&
8erotonin 8%n+ro'e
Ait/ St> Io/nG8 Aort
n+ SAMe>
li7i+o; urinr%
retention
Der'F
Di1/ore8i8;
1ruritu8; r8/
NeuroF tre'or8
Mi8!>F
SEROTONIN
S9NDROME
E8t7li8/ 8ui!i+e 1re!ution8 &or
8e6erel% +e1re88e+ 1tient8> Li'it
Euntit% o& !18ule8 +i81en8e+" /i*/
ri8$ in !/il+ren n+ +ole8!ent8>
3> A+'ini8ter +ru* in t/e 'ornin*>
@> Monitor 1tient &or re81on8e to
t/er1% &or u1 to 3 A$8 7e&ore
in!re8in* +o8e>
,> In8tru!t SO8 to in&or' nur8e &or n%
8i*n8 o& n1/%lxi8 or +6er8e +ru*
e&&e!t8
A'TER:
(> A88e88 'entl 8ttu8> Let SO in&or'
nur8e i& 1t> +e'on8trte8 8i*ni&i!nt
in!re8e in nxiet%; ner6ou8ne88 or
in8o'ni>
:> A88e88 &or n% 8exul 8i+e e&&e!t8
&ter +'ini8trtion -ere!tile
+%8&un!tion; +e!re8e+ li7i+o4
0> A88e88 &or 8en8iti6it% re!tion8 &ter
+'ini8trtion>
3> DOCUMENT /our; 'ount;
'e+i!tion n+ +ru* re!tion -i& n%4
@> Monitor 11etite n+ nutritionl
int$e> #ei*/ Aee$l%; note !ontinue+
Aei*/t lo88> A+Du8t +iet 8 tolerte+ to
8u11ort nutritionl 8ttu8>
,> Continull% o78er6e 1t> re81on8e to
+ru* t/er1% -6/8; l7 ex'84; 88e88
&or 8erotonin 8%n+ro'e
Sour!eF De*lin; I> H>;
J Vllern+; A> H>
-:)((4> D6i8K8 +ru*
*ui+e &or nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11 ((3=.
((3?4
Sour!eF De*lin; I> H>;
J Vllern+; A> H>
-:)((4> D6i8K8 +ru*
*ui+e &or nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11 ((3=.
((3?4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i; PennF
F>A> D6i8> -11 ((3=.((3?4
Sour!eF De*lin; I>
H>; J Vllern+; A>
H> -:)((4> D6i8K8
+ru* *ui+e &or
nur8e8>
P/il+el1/i; PennF
F>A> D6i8> -11
((3=.((3?4
Sour!eF De*lin; I> H>; J
Vllern+; A> H> -:)((4>
D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i;
PennF F>A> D6i8> -11
((3=.((3?4
Sour!eF De*lin;
I> H>; J
Vllern+; A> H>
-:)((4> D6i8K8
+ru* *ui+e &or
nur8e8>
P/il+el1/i;
PennF F>A>
D6i8> -11
((3=.((3?4
Sour!eF De*lin; I> H>; J Vllern+;
A> H> -:)((4> D6i8K8 +ru* *ui+e &or
nur8e8> P/il+el1/i; PennF F>A>
D6i8> -11 ((3=.((3?4