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NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms

) Generic Name fluoxetine Peak Unknown Trade Name Classification Dose Route Time/frequency Prozac antidepressants 20 mg PO Q day Onset Duration Normal dosage range 1-4 wks 2 wks 10 mg/day in the morning initially, may be increased (not to exceed 60 mg/day) For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, patients with concurrent chronic illness, or multiple drug therapy (dosage adjustments may be necessary), appears on Beers list. Geriatric patients are at increased risk for excessive CNS stimulation, sleep disturbances, and agitation. Common side effects Anxiety, drowsiness, headache, insomnia, nervousness, diarrhea, excessive sweating, pruritus, tremor, SEIZURES

Why is your patient getting this medication Depression Mechanism of action and indications (Why med ordered) Selectively inhibits the reuptake of serotonin in the CNS

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) ↑ CNS depression with sedative/hypnotics

Nursing Process- Assessment (Pre-administration assessment) Monitor mood changes. Inform physician or other health care professional if patient demonstrates significant increase in anxiety, nervousness, or insomnia, Monitor appetite and nutritional intake. Weigh weekly. Notify physician or other health care professional of continued weight loss. Adjust diet as tolerated to support nutritional status.

Lab value alterations caused by medicine Monitor CBC and differential periodically during therapy. Notify physician or other health care professional if leukopenia, anemia, thrombocytopenia, or increased bleeding time occurs, Proteinuria and mild ↑ in AST may occur during sensitivity reactions, may cause ↑ in serum alkaline phosphatase, ALT, BUN, creatine phosphokinase; hypouricemia, hypocalcemia, hypoglycemia or hyperglycemia, and hyponatremia Be sure to teach the patient the following about this medication Take fluoxetine exactly as directed. If a dose is missed, omit and return to regular schedule. Do not double doses or discontinue without consulting health care professional; discontinuation may cause anxiety, insomnia, nervousness, May cause drowsiness, dizziness, impaired judgment, and blurred vision, caution patient to change positions slowly to minimize dizziness. Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may minimize dry mouth. If dry mouth persists for more than 2 wk, consult health care professional regarding use of saliva substitute. Caution patient to wear protective clothing and use sunscreen to prevent photosensitivity reactions. Advise patient to notify health care professional if symptoms of sensitivity reaction occur or if headache, nausea, anorexia, anxiety, or insomnia persists. Emphasize the importance of follow-up exams to monitor progress. Encourage patient participation in psychotherapy. Assessment Evaluation Why would you hold or not give this Check after giving med? Increased sense of wellSensitivity reaction (urticaria, fever, being, Renewed interest in arthralgia, edema, carpal tunnel surroundings. May require syndrome, rash, hives, 1-4 wk of therapy to obtain lymphadenopathy, respiratory distress) antidepressant effects