NSG6005 Week 9 Project.pptx - Treatment of Depression with citalopram(Celexa NSG6005 Week 9 Sarah Toler What is Depression Clinical depression is a

NSG6005 Week 9 Project.pptx - Treatment of Depression with...

This preview shows page 1 out of 9 pages.

You've reached the end of your free preview.

Want to read all 9 pages?

Unformatted text preview: Treatment of Depression with citalopram (Celexa) NSG6005 Week 9 Sarah Toler What is Depression Clinical depression is a medical condition that goes beyond everyday sadness and can cause long-lasting symptoms and often interferes with one’s usual daily activities Depression can affect how one feels, how one thinks and acts Symptoms range from mild to moderate and include Feeling sad or having a depressed mood Loss of interest or pleasure in activities once enjoyed Changes in appetite — weight loss or gain unrelated to dieting Trouble sleeping or sleeping too much Loss of energy or increased fatigue Feeling worthless or guilty Difficulty thinking, concentrating or making decisions Thoughts of death or suicide (Parekh, 2017) Diagnosing Depression A medical provider must diagnose depression clinically Tools utilized to diagnose depression include Physical exam Lab testing Psychiatric evaluation Criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Risk factors for depression include personal or family history of depression, low self esteem, neuroticism, anxiety disorders, substance abuse, previous trauma, stress, loss of loved one (Depression, 2018) (Lyness, 2019) Pharmacological Intervention Options Nonselective Norepinephrine-Serotonin Reuptake Inhibitors (NNSRIs)- amitriptyline, clomipramine, doxepin Serotonin-Selective Reuptake inhibitors (SSRIs)- Prozac, Zoloft, Celexa, Lexapro Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)- Effexor, Cymbalta, Prestiq Norepinephrine-Dopamine Reuptake Inhibitors (NDRI)- Wellbutrin, Wellbutrin SR, Wellbutrin XL Serotonin Agonist Reuptake Inhibitors ( SARIs)- nefazadone, trazadone Norepinephrine- and Serotonin- Specific Agonist-Rameron Monoamine Oxidase Inhibitors (MAOIs)- phenelzine, tranylcypromine, isocarboxazid Benzodiazepines/ GABA-ergics (BZDs)- Xanax, Ativan, Resotril, Vaalium (Woo & Robinson, 2015) Pharmacodynamics of Citalopram (Celexa) Medication class- Selective Serotonin Reuptake Inhibitor (SSRI) Mechanism of action- increase levels of serotonin in the brain Route- oral, tablet form (10mg, 20mg, 40mg) Pharmacokinetics- Rapidly and well absorbed from the GI tract, peaks around 4 hours, food does not affect absorption Metabolism/Elimination- metabolized in the liver and excreted unchanged in urine, half life is roughly 35 hours Contraindications- not to be used with MAOIs or patients with QT prolongation Special Instructions- 20 mg/day is the maximum recommended dose for patients who are greater than 60 years of age, use cautiously with NSAIDs and other anticoagulant drugs such as ASA and Warfarin Black Label Warning- Risk for increased suicidal thinking and behavior especially in children and adolescents (Citalopram, n.d.) Goal of Treatment Relief and reduction of original symptoms of primary diagnosis of depression Continuation of both pharmacological intervention and psychotherapy for a time period of 4 to 9 months to help manage symptoms Eventual discontinuation of therapy by tapering process under medical provider supervision (Woo & Robinson, 2015) Patient Education Regarding Citalopram It may take anywhere from 6 to 12 weeks for one to see full effects of medication Do not stop taking medication abruptly, medication must be tapered by medical provider Common side effects include nausea, headache, dry mouth, dizziness, sexual dysfunction, nervousness, nausea, sleep disturbances, weight changes Do not drive or operate machinery until one knows how medication affects them Do not drink alcohol while taking this medication If patient misses a dose, take the dose of Celexa when you remember, but skip the missed dose if it’s almost time for your next dose. Patient should be aware of signs of toxicity. These symptoms include dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia (Citalopram, n.d.) (Woo & Robinson, 2015) Summary Depression is a serious medical condition if left untreated can cause major health problems as well as increased risk of suicide Depression affects roughly 20% of the population The most common drug therapy of choice are SSRIs Celexa is an SSRI that is shown to have little side effects, but should not be taken with QT prolongation shown on ECGs Contraindicated in liver patients due to being metabolized in the liver Should be closely monitored in elderly patients Common side effects include headaches, nausea, dizziness, dry mouth, sleeping disturbances, and weight changes All antidepressants have a Black Box Warning for risk of suicidal ideations especially in children and adolescents. References Citalopram. (n.d.). Retrieved from Depression (major depressive disorder). (2018, February 03). Retrieved from Lyness, J. (2019, March 12). Patient education: Depression in adults (Beyond the Basics). Retrieved from Parekh, R. (2017, January). What is Depression. Retrieved from Simon, G. (2019, March 12). Patient education: Depression treatment options for adults (Beyond the Basics). Retrieved from ? topicRef=4868&source=see_link Woo, T. & Robinson, M. (2015). Pharmacotherapeutics for Advanced Practice Nurse Prescribers with Davis Plus eResourses , 4th ed. F.A. Davis Company. ISBN: 9780803638273 ...
View Full Document

  • Fall '16
  • Selective serotonin reuptake inhibitor,  Tools,  Changes

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Stuck? We have tutors online 24/7 who can help you get unstuck.
A+ icon
Ask Expert Tutors You can ask You can ask You can ask (will expire )
Answers in as fast as 15 minutes