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NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Trade Name Classification Dose Route Time/frequency Name Remeron Antidepressants 15 mg PO Q Day at bedtime Mirtazapine Peak Onset Duration Normal dosage range 6 weeks or 1-2 weeks Unknown 15 mg/day as a single bedtime dose initially; may be more increased q 1-2 weeks up to 45 mg/day Why is your patient getting this medication Treatment of new onset depression r/t resent loss of spouse Mechanism of action and indications (Why med ordered) Potentiates the effects of norepinephrine and serotonin. Therapeutic Effects: antidepressant action which may develop over several weeks

For IV meds, compatibility with IV drips and/or solutions N/A

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity. Concurrent MAO inhibitor therapy. Use cautiously in history of seizures; history of suicide attempt; may increase the risk of suicide attempt especially during early therapy. Common side effects CNS: drowsiness, abnormal dreams, abnormal thinking, agitation, anxiety, apathy, confusion, dizziness, malaise, weakness. EENT: sinusitis. RESP: dyspnea, increased cough. CV: edema, hypotension, vasodilation. GI: constipation, dry mouth, increased appetite, abdominal pain, anorexia, elevated liver enzymes, nausea, vomiting. GU: urinary frequency. DERM: pruritus, rash. F&E: increased thirst. HEMAT: agranulocytosis. METAB: weight gain, hypercholesterolemia, increased triglycerides. MS: arthralgia, back pain, myalgia. NEURO: hyperkinesias, hyperesthesia, twitching. MISC: flu like syndrome. Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine medicines (ask patient specifically) Assess CBC ad hepatic function before and periodically May cause hypertension, seizures, and death when during therapy used with MAO inhibitors. Increased CNS depression Be sure to teach the patient the following about this with other CNS depressants medication Take as directed, do not double doses, may cause dizziness and drowsiness. Change positions slowly to avoid orthostatic hypotension. Nursing Process- Assessment Assessment Evaluation (Pre-administration assessment) Why would you hold or not give this Check after giving Assess mental status med? Evaluate symptoms of Significant changes in BP. Seizure depression, sense of well activity. being, increase in appetite, energy level, improvement in sleeping patterns