Purpose
Acts by inhibiting norepinephrine and dopamine uptake, and is referred to as a norepinephrine-dopamine reuptake inhibitor. |
Therapeutic Uses
Treatment for depression |
Alternative to SSRIs and SNRIs for clients unable to tolerate sexual dysfunction adverse effects of these antidepressants |
Aid for smoking cessation |
Prevention of seasonal pattern depression |
Alternative treatment choice for attention-deficit disorder |
Complications
Complication |
Nursing Action and Education |
Headache, dry mouth, GI distress, Constipation, Increased heart rate, Hypertension, Restlessness, and Insomnia |
Treat headache with mild analgesic. Observe for effects and notify the provider if intolerable. Sip on fluids to treat dry mouth and increase dietary fiber to prevent constipation. |
Nausea, Vomiting, Anorexia, Weight Loss |
Monitor weight and food intake |
Seizures |
Avoid administering to clients at risk for seizures (a client who have head injuries). Monitor for seizures, and treat accordingly. |
Contraindications/ Precautions
Bupropion is a pregnancy risk category B. |
Notify the provider if pregnant or breastfeeding. The provider will determine is the risks of taking the medication out-weigh the benefiits. |
Contraindicated in clients taking MAOIs. |
Contraindicated for clients who have seizure disorders or eating disorders. |
Interactions
Interaction |
Nursing Action |
MAOIs (phenelzine) increase the risk for toxicity |
MAOIs should be discontinued 2 weeks prior to beginning treatment with bupropion. |
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Purpose
Referred to as a serotonin-norepinephrine disinhibitor. |
It increases the release of serotonin and norepinephrine by blocking the presynaptic receptors, and thereby increases thee amount of neurotransmitters available for impulse transmission. |
Nursing Action
Therapeutic effects can occur sooner with less sexual dysfunction than with SSRIs |
Mirtazapine is generally well tolerated. Clients can experience sleepiness that can be exacerbated by other CNS depressants (alcohol, benzodiazepines), weight gain, and elevated cholesterol. |
Client Education
Take at bedtime, can be used as sleep aid. |
Purpose
Both blocks serotonin and works with a serotonin agonist at receptor site (first medication to work in this way). |
Nursing Action
Contraindicated with SSRIs and SNRIs (serotonin syndrome), and other serotonin receptor agonists (buspirone and phenothiazines). Stop MAOIs at least 14 days before starting vilazodone. |
Teach manifestations of serotonin syndrome to client and instruct them when to notify provider. |
Monitor for sucidal ideation |
Many adverse effects are similar to those of SSRIs and SNRIs. |
Take with food to help increase absorption. |
Client Education
Avoid grapefruit juice while taking Vilazodone because grapefruit juice inhibits CYP3A4 metabolism resulting in an increase in the medication blood level. |
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Purpose
Selectively inhibits the reuptake of serotonin and norepinephrine. |
Nursing Action
Rapidly absorbed in 1 hr when taken without food. |
Adverse effects are sleepiness, headache, dizziness, blurred vision, dry mouth, nausea, constipation, weight gain, and sexual dysfunction |
Stop MAOIs at least 14 days before starting nefazodone. |
Purpose
Moderate selective blockage of serotonin receptors, which allows more serotonin to be available for impulse transmission. |
Nursing Action
Usually used with another antidepressant agent. |
Sedation is a potential problem, can be indicated for a client who has insomnia. |
Priapism is a potential adverse effect. Instruct clients to seek medical attention immediately if this occurs |
Don't drink grapefruit juice as it inhibits CYP3A4 metabolism resulting in an increase in the medication blood level resulting in toxicity. |
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