Clinical Medications WorksheetsGeneric Nameescitalopram

Trade NameLexapro

ClassificationAntidepressant

Dose10 mg

Routepo

Time/frequencyQD

Peakunknown

Onset1-4 wk

Durationunknown

Normal dosage range10-20 mg once daily

Why is your patient getting this medicationdepression

For IV meds, compatibility with IV drips and/or solutionsN/A

Mechanism of action and indications(Why med ordered)Selectively inhibits the reuptake of serotonin in the CNS. Anti depressant action

Nursing Implications (what to focus on) Contraindications/warnings/interactionsHypersensitivity

Common side effectsInsomnia, diarrhea, nausea, dizziness, drowsiness, fatigue

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)Darvocet: Sedatives, tranquilizers, muscle relaxants, antidepressants, and other central nervous system (CNS) depressants may have additive CNS- and/or respiratory-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 system- and/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 5-HT1A 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

Lab value alterations caused by medicineNone significant

Be sure to teach the patient the following about this medicationDo not stop abruptly, do not double dose, avoid alcohol and other CNS depressants

Lexapro (escitalopram oxalate)

mechanism is unknown but may involve a pharmacodynamic interaction, as serotonin reuptake inhibitors have been reported to interfere with platelet function.Nursing Process- Assessment(Pre-administration assessment)monitor mood changes and level of anxietyassess for suicidal tendencies

AssessmentWhy would you hold or not give this med?

Suicidal statements or mood changes

EvaluationCheck after givingIncreases sense of well being, renewed interest in surroundings. May take 1-4 weeks

Lexapro (escitalopram oxalate)