You are on page 1of 3

DRUG STUDY Drug Data Generic Name fluoxetine Trade Name Prozac, Sarafem !

atients Dose Classification Therapeutic# antide!re""ant" !harmacologic Selecti#e "erotonin reu!ta$e in%i&itor"'SS()"* !regnanc% Categor% , Mechanism of Action Selecti#ely in%i&it" t%e reu!ta$e of "erotonin in t%e +,S. !harmaco*inetics A# -ell a&"or&ed after oral admini"tration. D# +ro""e" t%e &lood. &rain &arrier. M-.# +on#erted &y t%e li#er to norfluoxetine '!rimarily &y +/P201 i"oenzyme*, anot%er antide!re""ant com!ound2 t%e +/P201 enzyme "y"tem ex%i&it" genetic !olymor!%i"m '345 of !o!ulation may &e !oor meta&olizer" and may %a#e "ignificantly increa"e fluoxetine concentration" and an increa"ed ri"$ of ad#er"e effect"*. 6luoxetine and norfluoxetine are mo"tly meta&olized &y t%e li#er2 125 excreted &y $idney" a" unc%anged fluoxetine, 45 a" unc%anged norfluoxetine. "nset 1.47$" !ea* un$no7n Duration 27$" Drug /alf 0ife 1.8 day" Indication General Indications 9a:or de!re""i#e di"order. &"e""i#e com!ul"i#e di"order ' +0*. ;ulimia ner#o"a. Panic di"order. 0e!re""i#e e!i"ode" a""ociated 7it% &i!olar ) di"order '7%en u"ed 7it% olanza!ine*. <reatment re"i"tant de!re""ion '7%en u"ed 7it% olanza!ine*. Sarafem# Premen"trual dy"!%oric di"order 'P900*. Unla eled Use# =norexia ner#o"a> =0?0, 0ia&etic neuro!at%y, 6i&romyalgia, &e"ity, (aynaud@" !%enomenon, Social anxiety di"order '"ocial !%o&ia*, Po"t. traumatic "tre"" di"order 'P<S0*. !atients Actual Indication Contraindications ?y!er"en"iti#ity2 +oncurrent u"e or u"e 7it%in 14 day" of di"continuing 9= in%i&itor" 'fluoxetine "%ould &e di"continued at lea"t 5 7$ &efore 9= t%era!y i" initiated*2 +oncurrent u"e of !imozide2 +oncurrent u"e of t%ioridazine 'fluoxetine "%ould &e di"continued at lea"t 5 7$ &efore t%ioridazine t%era!y i" initiated*. !recaution Se#ere %e!atic or renal im!airment 'lo7er/le"" freAuent do"e may &e nece""ary*2 ?i"tory of "eizure"2 0e&ilitated !atient" 'increa"ed ri"$ of "eizure"*2 0ia&ete" mellitu"2 Patient" 7it% concurrent c%ronic illne"" or multi!le drug t%era!y 'do"e ad:u"tment" may &e nece""ary*2 Patient" 7it% im!aired %e!atic function ' decrea"e do"e"/ increa"e do"ing inter#al may &e nece""ary*2 9ay increa"e ri"$ of "uicide attem!t/ideation e"!ecially during early treatment or do"e ad:u"tment2 ;> B"e during t%ird trime"ter may re"ult in neonatal "erotonin "yndrome reAuiring !rolonged %o"!italization, Adverse Reaction CNS# ,CB( LCP<)+ 9=L)D,=,< S/,0( 9C, SC)EB(CS, SB)+)0=L <? BD?<S, anxiety, dro7"ine"", %eadac%e, in"omnia, ner#ou"ne"", a&normal dream", dizzine"", fatigue, %y!omania, mania, 7ea$ne"". ..NT# "tuffy no"e, #i"ual di"tur&ance". Resp# coug%. C1# c%e"t !ain, !al!itation". GI# diarr%ea, a&dominal !ain, a&normal ta"te, anorexia, con"ti!ation, dry mout%, dy"!e!"ia, nau"ea, #omiting, 7eig%t lo"". GU# "exual dy"function, urinary freAuency. Derm#A"7eating, !ruritu", eryt%ema nodu"um, flu"%ing, ra"%e". .ndo# dy"menorr%ea. 2 and .# %y!onatremia. MS# art%ralgia, &ac$ !ain, myalgia. Neuro# tremor. Misc# SC( < ,), S/,0( 9C, allergic reaction", fe#er, flu.li$e "yndrome, %ot fla"%e", "en"iti#ity reaction. Nursing Responsi ilities ,efore 1. =""e"" !atient@" mood. 2. =""e"" !atient@" mental "tatu". 8. =""e"" if !atient %ad any !a"t "uicidal tendencie". 4. +onfirm medication from doctor@" order". 5. =""e"" !atient for "en"iti#ity reaction to medication. During 1. +onfirm !atient@" identity. 2. 9ay admini"ter mediation 7it% food to reduce D) irritation. 8. 0o not go o#er t%e recommended do"e. 4. Practice a"e!tic tec%niAue. 5. 0o not cru"% or o!en C( !re!aration". After 1. &"er#e !ro!er documentation of admini"tered medication. Cn"ure t%at !atient %a" fully "7allo7ed oral form of medication. &"er#e !atient@" &e%a#ior clo"ely for atlea"t 15.80 minute" after admini"tration. )n"truct !atient to mo#e "lo7ly to !re#ent dizzine"". )n"truct !atient to re"t to decrea"e ri"$ of fall".

Minimum Dose !"#5mg/day Ma$imum Dose !"#80mg/day Contents fluoxetine Availa ilit% and color Ta lets# 10 mg, 20 mg. Capsules# 10 mg, 20 mg, 40 mg. Dela%ed& release capsules '!ro(ac )ee*l%+# 90 mg. "ral solution 'mint flavor+#20 mg/5 mL. Routes of administration P

2. 8.

4. 5.

re"!iratory and nutritional "u!!ort. 9ay cau"e "edation in infant2 Lactation> 9ay cau"e "edation in infant2 di"continue drug or &ottle.feed2 Pedi> (i"$ of "uicide ideation or attem!t may &e greater in c%ildren or adole"cent" '"afe u"e in c%ildren F 8 yr not e"ta&li"%ed*2 Deri> =!!ear" on ;eer" li"t. Deriatric !atient" are at %ig% ri"$ for exce""i#e +,S "timulation, "lee! di"tur&ance", and agitation. .Drug interaction &drug to drug 0i"continue u"e of MA" inhi itors for 14 day" &efore fluoxetine t%era!y2 com&ined t%era!y may re"ult in confu"ion, agitation, "eizure", %y!erten"ion, and %y!er!yrexia '"erotonin "yndrome*. 6luoxetine "%ould &e di"continued for at lea"t 5 7$ &efore 9= in%i&itor t%era!y i" initiated. +oncurrent u"e 7it% pimo(ide may )ncrea"e ri"$ of G< inter#al !rolongation. )ncrea"e le#el" of thiorida(ine may increa"e ri"$ of G< inter#al !rolongation 'concurrent u"e contraindicated2 fluoxetine "%ould &e di"continued for at lea"t 5 7$ &efore t%ioridazine i" initiated*. )n%i&it" t%e acti#ity of cytoc%rome

P450 201 enzyme in t%e li#er and increa"e effect" of drug" meta&olized &y t%i" enzyme "y"tem. Medications that inhi it the !345 en(%me s%stem 'including ritonavir, sa6uinavir, and efaviren(* may increa"e ri"$ of de#elo!ing t%e "erotonin "yndrome*.

Source# 0eglin, H. et. =l. 2009. 0a#i"@" 0rug Duide for ,ur"e". 12 t% ed. 6.=. 0a#i". !!.594.100

You might also like