DRUG STUDY

Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): 25- Potentiates the Various Hypersensitivity; CNS: drowsiness, Monitor blood pressure and
50mg 3-4 times effect of forms of cross-sensitivity fatigue, agitation, pulse rate prior to and during
IMIPRAMINE daily (no to serotonin and depression. with other confusion, initial therapy
exceed norepinephrine. Enuresis in antidepressants may hallucinations,
Brand Name:
TOFRANIL, MELIPRAMINE 300mg/day); total Has significant children occur; angle-closure insomnia Monitor plasma levels in
daily dose may be anticholinergic glaucoma; treatment-resistant patients
Classification: given at bedtime properties hypersensitivity to EENT: blurred vision,
Therapeutic: tartrazine or dry eyes Monitor weight and BMI
antidepressants sulphites; Recent initially and periodically
Pharmacologic: tricyclic MI, known history of CV: Arrhythmias, throughout therapy
antidepressants
QTC prolongation hypotension, ECG
PREGNANCY CATEGORY C heart failure changes For overweight/obese
individuals, obtain FBS and
GI: constipation, dry cholesterol levels Refer as
mouth, nausea, appropriate for
paralytic ileus, weight nutrition/weight management
gain and medical management

GU: urinary retention, Obtain weight and BMI initially

decreased libido and regularly throughout
therapy
DERM: photosensitivity
Assess for sexual dysfunction
ENDO: gynecomastia (decreased libido; erectile
dysfunction)
HEMAT: blood
dsycrasias Pedi, Geri; monitor baseline
and periodic ECGs in elderly
patients or patients with heart
DRUG STUDY
disease and before increasing
dose with children treated for
enuresis. Amy cause prolonged
PR and QT intervals and may
flatten T waves

Depression: assess mental

status (orientation, mood,
behaviour) frequently.
Confusion, agitation, and
hallucinations may occur
during initiation of therapy and
may require dosage reduction.
Assess for suicidal tendencies,
especially during early therapy.
Restrict amount of drug
available to a patient

Enuresis: assess frequency of

bedwetting during therapy. Ask
patient or caretaker to
maintain diary.
 DRUG STUDY
Drug Name Dosage Action Indication Contraindication Side Effects Nursing Responsibilities
Generic Name: PO (Adults): Phenelzine relieves symptoms To treat Cardiovascular CNS: Agitation, •Use phenelzine
Initial: 1 mg/kg of unipolar depressive depression disease; dizziness, cautiously in patients with
PHENELZINE daily, increased disorders by inhibiting the cerebrovascular drowsiness, epilepsy because drug
gradually as enzyme monoamine oxidase disease; heart headache, may alter seizure
Brand Name:
NARDIL prescribed and (MAO). Normally, MAO breaks failure; hepatic overstimulation, threshold.
tolerated. down disease; history of restlessness,
Classification: Maintenance: 45 monoamineneurotransmitters, headaches; sedation, sleep •Use phenelzine
Therapeutic: mg daily. such as serotonin, as shown hypersensitivity to disturbance, suicidal cautiously in patients with
antidepressants Maximum: below left. phenelzine or its ideation, weakness diabetes mellitus because
Chemical Class: 90 mg daily components; insulin sensitivity may
Hydrazine derivative
hypertension; CV: Bradycardia, increase, predisposing
PREGNANCY CATEGORY pheochromocytoma; edema, hypertensive patient to hypoglycemia.
C severe renal crisis, orthostatic
impairment; use of hypotension, •Expect to observe some
anesthetics, palpitations, therapeutic effect within
antihypertensives, tachycardia 7 to 10 days, but keep in
bupropion, mind that full effect may
buspirone, EENT: Blurred vision, not occur for 4 to 8
carbamazepine, CNS dry mouth, weeks.
depressants, photophobia
cyclobenzaprine, •Monitor cardiovascular
dextromethorphan, ENDO: Hypoglycemia status closely for changes
meperidine, in diabetic patients in heart rate (especially if
selective serotonin- patient receives more
reuptake inhibitors, GI: Abdominal pain, than 30 mg daily) and
sympathomimetics, constipation, signs of life-threatening
or tricyclic diarrhea, elevated hypertensive crisis.
antidepressants; use liver function test Question patient often
about headaches and
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within 14 days of results, increased palpitations. If either
other MAO inhibitor. appetite, nausea occurs, notify prescriber
and expect to discontinue
GU: Impotence, drug.
priapism, sexual
dysfunction, urinary •Keep phentolamine
frequency, urine readily available to treat
retention hypertensive crisis. Give 5
mg by slow I.V., as
MS: Muscle prescribed, to reduce
twitching blood pressure without
causing excessive
SKIN: Diaphoresis, hypotension. Use external
rash cooling measures, as
prescribed, to manage
Other: fever.
Hypernatremia,
weight gain •To avoid hypertensive
crisis, expect to wait 10 to
14 days, as prescribed,
when switching patient
from one MAO inhibitor
to another or when
switching from a
dibenzazepine-related
drug, such as amitriptyline
or perphenazine.

•Watch closely for

suicidal tendencies,
DRUG STUDY
especially in children,
adolescents, and young
adults and especially
when therapy starts or
dosage changes.