4. A client in your care is very anxious about taking his newly prescribed medic

Question

4. A client in your care is very anxious about taking his newly prescribed
medication for depression, Pristiq. You attempt to alleviate his concerns
about taking a new drug through medication education.
a. Explain the FDA’s process of approving new drugs.
b. Discuss the principles of adherence and efficacy in relation to
psychotropic medications.
c. Identify the classification, neurotransmitters involved, and the
disorders for which the client’s medication is prescribed.
d. What is the action, recommended dosage, route of administration,
side effects, potential adverse effects, contraindications, and
nursing implications for the client’s medication, Pristiq?

Explanation / Answer

a. Explain the FDA’s process of approving new drugs.

Animals tested

IND application

Phase I-20-80 sample size

Phase II- 100 sample size

Phase III- 1000 sample size

Phase IV- monitoring

Review meeting

NDA application

Application Reviewed

Drug Labelling

Facility inspection

Drug Approval

b. Discuss the principles of adherence and efficacy in relation to psychotropic medications:

Counselling

Cognitive behavioural therapy

Motivational interviewing

cognitive adaptive trainingsuch as alarms, pill boxes, activity calendars, organisation of personal belongings

Support services such as transportation arrangement to pharmacies and obtaining insurance benefits.

c. Identify the classification, neurotransmitters involved, and thedisorders for which the client’s medication is prescribed.

Neurotransmitters are the chemical messengers which carry information between the neurons in Brain. Decreased secretion of nor-epinephrine, seratonin and dopamine resulting in depression whereas, decreased secretion of Gamma Amino Butyric Acid resulting in Anxiety. Pristiq is a drug comes under classification of serotonin-norepinephrine reuptake inhibitors[SNRS] play a role in anxiety and depression.

d. What is the action, recommended dosage, route of administration, side effects, potential adverse effects, contraindications, and nursing implications for the client’s medication, Pristiq?

Action: serotonin-norepinephrine reuptake inhibitors[SNRS] by affecting these levels in brain

Dosage:50mg once daily with or without food

Route: Oral. Swallowed full with fluid

Side effcets:constipation, dizziness, drowsiness, insomnia, nausea, decreased appetite, hyperhidrosis, and xerostomia and other essfects include blurred vision, tremors, vomiting, chills, abnormal dreams and yawning

Contraindications:pregnancy, lactation, Glaucoma, suicidal thoughts, liver, heart and kidney diseases, seizures.

Nurses role: Collecting information on allergic reactions to desvenlafaxine

Use of MAO inhibitor within 7 days before or 14 days after is contraindicated for pristiq

Information on adverse effects, when to consult a doctor

Information on importance of drug adherence

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