PSYCHIATRIC DRUG:

- Selective serotonin reuptake inhibitor (SSRI)

SSRI medications:
1. Citalopram
2. Escitalopram
3. Fluoxetine
4. Fluvoxamine
5. Paroxetine
6. Sertraline
7. Vilazodone

- Serotonin- hormones stabilizes our mood (may anti-depressant effect)

- Administer SSRI but be vigilant and monitor the pt for adverse effects.

- May have effect to those patients taking undocumented herbal

Side effects:

1. Nausea and vomiting

2. Cramping
3. Diarrhea
4. Dry mouth
5. CNS stimulation including agitated.
6. Diaphoresis
7. Significant changes on the BP of the pt: increase or decrease.
8. Pt tent to have photosensitivity.
9. Insomnia
10. Sudden Nervousness
11. Headache
12. Weight gain or loss
13. Decrease in libido.
14. Afatti (no emotions, don’t care)
15. Tremors

Intervention:

1. SSRI interacts with numerous medications.

2. Monitor the VS of the pt.
3. Monitor the weight.
4. Initiate safety precautions (Handrails, assistive devices)
5. Do not drink alcohol when taking the medications.
6. Monitor for suicidal client when suddenly well and energetic.
7. Instruct client taking fluoxetine to take the medication early to not disturb his sleep in the night.
8. For pt with long term therapy, may have problems in liver and renal. LIVER FUNCTION RATE,
RENAL FUNCTION RATE.
9. Monitor WBC. If decrease, discontinue medication.
 10. Priapism- Painful hard prolonged penal erection. Inform physician.
11. Prior to administration, tell the pt the effect on libido of the medicine.
12. Instruct the client that if he change position, do it slowly.
13. Prevent for longed exposure to light.
14. Educate about the potential discontinuation syndrome.
15. Be aware of potential for serotonin syndrome. (Increased temp, muscle rigidity, increased CKMB)
16. Pregnancy, approval of physician is needed before taking the medication.
17. Monitor the medication response in children, adolescent, older adult.

- Tricyclic Antidepresssants

Tricyclic Antidepressants
1. Amitriptyline
2. Amoxapine
3. Clomipramine – use to treat OCD.
4.Desipramine
5. Doxepin
6. Imipramine
7. Nortriptyline
8. Protriptyline
9. Trimipramine

-blocks the reuptake of norepinephrine and serotonin. Presynaptic junction. Acetylcholine

- primarily used to treat and manage depression

- this drugs may also manage seizures.

- may also reduce the effective of anti-hypertensive medications.

- may have CNS depression when you are taking medication while drinking alcohol and antihistamine.

- Hypertensive crisis may occur if you take the medication with mawi

- cardiac toxicity can occur and all clients should receive ECG before the treatment.

- can have an overdose.

OVERDOSE: medical emergency

1. Check for airway and maintain patency of airway.

2. Administer oxygenation.

3. Monitor VS simultaneously

4. Ready ECG.
5. Gastric lavage and gavage. (Activated charcoal)

6. Prepare to administer Physostigmine and Antidysrhythmic medications (IV)

S/S

- Dry mouth
- Hirap sa pag-ihi or pagdumi
- Dilated pupils
- Blurred vision
- Decreased GI motility (constipation)
- Photosensitivity
- Cardiovascular disturbances (tachycardia, orthostatic hypotension, dysrhythmia)
- Sedation
- Seizure
- Weight gain
- Anxiety, restlessness, and irritability
- Increase or decrease of libido. (Disturbance in ejaculation and erection) (wag pagsabayin ang
anti-depressant and robust or Viagra)

Interventions:

1. Monitor for suicidal tendencies.

2. Instruct the client to change the position slowly to prevent orthostatic hypotension.
3. Monitor for patterns of daily bowel activity.
4. Assess for urinary retention.
5. Assess for liver and renal function.
6. Antidepressant are administered with full stomach, and food or with milk. Administer before
going to bed.
7. Instruct the client to avoid alcohol. Do not take any unprescribed medication.
8. Instruct the client to avoid driving.
9. Encourage oral hygiene and drink water and bring candy.
10. Inform the client that it will take 2-4 weeks to see the full effect of the drug.