Author Question: A patient being treated for depression has been taking 300 mg amitriptyline (Elavil) daily for ... (Read 53 times)

shenderson6 · **on:** Jul 19, 2018

A patient being treated for depression has been taking 300 mg amitriptyline (Elavil) daily for nearly a year.

She calls her case manager at the mental health clinic, stating she stopped taking her antidepressant 2 days ago and has developed something like the flu, with cold sweats, nausea, a rapid heartbeat, terrible nightmares when she sleeps, but no other symptoms. How should the nurse respond? a. Advise her to go to the nearest emergency department for an evaluation.
b. Tell her to take two aspirin, drink plenty of fluids, and call her family doctor.
c. Explain it may be withdrawal; tell her to take one Elavil and contact her doctor.
d. Direct her to take the medicine every other day for 2 weeks, then stop.

Question 2

The CMA is administering an antianxiety medication to a client. Monitoring side effects is the responsibility of which member of the health care team?

a. Nurse
b. CMA
c. Physician
d. Therapist

kardosa007 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

C
The patient has symptoms associated with abrupt withdrawal of the tricyclic antidepressant. Taking a dose of the drug will ameliorate the symptoms, and discussing her plans with the physician will allow her to discuss the advisability of going off the medication and to be given a gradual withdrawal schedule if discontinuation is the decision. This situation is not a medical emergency, so the ER is not indicated. The situation is not normal; she is likely experiencing withdrawal and is also at risk of worsening or triggering her depression if she stops her medication, so the decision should be made in collaboration with a mental health professional. Aspirin would have no benefit in this situation. Taking the medication every other day would reduce the drug levels she is exposed to, but not in a gradual way; tapering the dosage gradually is needed instead.

Answer to Question 2

A
While all care providers should be aware of the actions and side effects of the client's medication, the nurse remains responsible to for monitoring drug effectiveness and adverse reactions.