Author Question: A patient who has fibromyalgia is diagnosed with major depression. The provider orders a TCA. The ... (Read 146 times)

nenivikky · **on:** Jul 23, 2018

A patient who has fibromyalgia is diagnosed with major depression. The provider orders a TCA. The nurse will teach this patient to:

a. avoid foods containing tyrosine.
b. consume alcohol in moderation.
c. sit or lie down when feeling lightheaded.
d. take the medication in the morning.

Question 2

A patient who has been taking an SSRI tells the nurse that the drug has caused reduced sexual performance, weight gain, and sedation. The nurse will suggest that the patient ask the provider about using which drug?

a. Bupropion (Wellbutrin)
b. Imipramine (Tofranil)
c. Isocarboxazid (Marplan)
d. Trazodone (Oleptro)

carojassy25 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
Orthostatic hypotension can occur with TCAs. Patients should be advised to sit or lie down if they feel lightheaded to prevent falls. Foods containing tyrosine cause adverse effects in patients taking MAOIs. Patients taking TCAs should be counseled to avoid all alcohol. Because TCAs cause sedation, the medication should be taken at bedtime.

Answer to Question 2

ANS: A
Bupropion does not cause weight gain, sexual dysfunction, or sedation, so it may be a useful adjunct to or substitute for an SSRI when those side effects become intolerable. Imipramine causes sedation. Isocarboxazid is an MAOI and is not used unless other drugs are ineffective. Trazodone causes sedation.