Lehn's CH 32 & 33 Pharmacology Elaborate Exam 2023

Lehn's CH 32 & 33 Pharmacology Elaborate Exam 2023 The nurse is planning care for a patient taking imipramine (Tofranil). Which finding, if present, would most likely be an adverse effect of this drug? Sedation and dry mouth The nurse is monitoring a patient with depression in the early phase of treatment with amitriptyline (Elavil). Which question is most important for the nurse to ask the patient? "Have you had any changes in your mood or anxiety level?" The nurse is caring for a patient receiving fluoxetine (Prozac) for depression. Which adverse effect is most likely associated with this drug? Sexual dysfunction The nurse is caring for a patient in the emergency department who reports the onset of agitation, confusion, muscle twitching, diaphoresis, and fever about 12 hours after beginning new prescription for escitalopram (Lexapro). Which is the most likely explanation for these symptoms? Serotonin syndrome The nurse is preparing to adminster phenelzine (Nardil) to a patient with depression. Why is this durg considered a second- or third-line agent in the treatment of depression? It has more side effects and drug interactions A nurse teaches a patient who takes an MAOI about important dietary restrictions. Which foods will the nurse caution that patient to avoid? Aged cheese and sherry The nurse is caring for a group of patient being treated for depression. Why might an SSRI be chosen over a TCA? To reduce the risk of suicide with overdose The nurse identifies which most common serious adverse effect of TCA therapy? Orthostatic hypotension The nurse is teaching a patient who has a new prescription for citalopram (Celexa). Which statement is appropriate to include in the teaching plan? (Select all) -"This medication may cause some sexual side effects. Let you healthcare provider know about this if it occurs." -"When you stop taking this medication, you . should not withdraw it abruptly." -"Let your family or your healthcare provider know if you experience a worsening mood, agitation, or increased anxiety." Which instruction does the nurse include when teaching a patient about phelezine (Nardil) therapy? (Select all) -"If you experience a severe headache, inform your healthcare provider." -"Avoid eating avocados when taking this drug." Which drug does the nurse identify as a selective serotonin reuptake inhibitior? (select all) -Fluoxetine (Prozac) -Sertraline (zoloft) The nurse knows that which statements about postpartum depression are true? (Select all) -about 80% of women experience depressive symptoms after giving birth -thyroid insufficiency has been indicated as a contributing factor in postpartum depression -Sertraline (Zoloft) is the drug of choice for treating postpartum depression in breast feeding mothers Potential adverse effects of TCAs -Anticholingeric effects (dry mouth, blurred vision, constipation, tachycardia, urinary retention) -sedation -orthostatic hypotension Example of a TCA? Imipramine (Tofranil) Examples of a SSRI? -Fluoxetine (Prozac) -Citalopram (Celexa) -Sertaline (zoloft) Side effects of SSRIs? -sexual dysfunction -nausea -HA -CNS stimulation When can Serotonin syndrome occur and what are they symptoms? -Can occur within 2 to 72 hours after initiation of treatment with SSRIs -Symptoms include altered mental status, incoordination, myoclonus, hyperrelexia, excessive sweating, tremor, and fever Why are MAOIs considered second or third line treatment? -MAOIs can trigger hypertensive crisis when the patient eats foods high in tyramine -There are a lot of drug-drug interactions Example of an MAOI? Phelezine (Nardil) Foods that contain tyramine can produce hypertensive crisis in those taking? MOAIs SSRIs should be withdrawn slowly to prevent? -dizziness -HA -dysphoria Examples of tyramine-rich foods. -aged cheese -chianti -avocados *they should also avoid ginseng* What is the drug of choice for postpartum depression? Sertaline (Zoloft) The nurse is caring for a patient with bipolar disorder who is taking lithium. Which abnormal laboratory value is most essential for the nurse to communicate to the healthcare provider because this patient is taking lithium? Sodium level of 128 mEq/L What is the normal sodium level? 135-145 mEq/L