Lexapro(escitalopram Oxalate)

Clinical Medications Worksheets Generic Name Trade Name Classification escitalopram Lexapro Antidepressant Peak Onset Duration unknown 1-4 wk unknown 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. Anti depressant action

Dose Route Time/frequency 10 mg po QD Normal dosage range 10-20 mg once daily For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity Common side effects Insomnia, diarrhea, nausea, dizziness, drowsiness, fatigue

Lexapro (escitalopram oxalate)

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine medicines (ask patient specifically) None significant Darvocet: Sedatives, tranquilizers, muscle relaxants, Be sure to teach the patient the following about this medication antidepressants, and other central nervous system (CNS) Do not stop abruptly, do not double dose, avoid alcohol and other depressants may have additive CNS- and/or respiratoryCNS depressants depressant effects with propoxyphene. Misuse of propoxyphene, either alone or in combination with other CNS depressants, has been a major cause of drug-related deaths, particularly in patients with a history of emotional disturbances, suicidal ideation, or alcohol and drug abuse. In a large Canadian study, propoxyphene use was also associated with a 60% increased risk of hip fracture in the elderly, and the risk was further increased by concomitant use of psychotropic agents (sedatives, antidepressants, neuroleptics), presumably due to additive psychomotor impairment. Therefore, these drugs may constitute a dangerous combination in certain susceptible populations. Reglan: Coadministration of metoclopramide with the serotonin reuptake inhibitors, sertraline and venlafaxine, has been associated with development of the serotonin syndrome and severe extrapyramidal reactions. Morphine, Restoril, Phenergan: Central nervous systemand/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. Percocet: A case report suggests that use of serotonin reuptake inhibitors with oxycodone may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. However, unlike other analgesics such as phenylpiperidine opioids (e.g., meperidine) and tramadol, oxycodone is not known to possess serotonergic activity and has not previously been associated with the serotonin syndrome. Lisinopril: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis. Lovenox: Serotonin reuptake inhibitors may potentiate the risk of bleeding in patients receiving heparin therapy. The exact mechanism is unknown but may involve a pharmacodynamic interaction, as serotonin reuptake inhibitors have been reported to interfere with platelet function. Nursing Process- Assessment Assessment Evaluation (Pre-administration assessment) Why would you hold or not give this med? Check after giving monitor mood changes and level of anxiety Increases sense of well being, assess for suicidal tendencies Suicidal statements or mood changes renewed interest in surroundings. May take 1-4 weeks

Lexapro (escitalopram oxalate)