Author Question: The psychiatrist on call comes in to evaluate J.B. after meeting with J.B., the psychiatrist writes ... (Read 128 times)

formula1

  • Hero Member
  • *****
  • Posts: 666
The psychiatrist on call comes in to evaluate J.B. after meeting with J.B., the psychiatrist writes an order for escitalopram (Lexapro) 10 mg daily at bedtime.
 
  J.B. is scheduled to see the psychiatrist the day after he
  is discharged from the hospital.
 
  What special instructions will you give him regarding the Lexapro? Select all that apply.
  a. The full effects of the medication might not be seen for 4 to 6 weeks.
  b. The medication may cause nausea, dry mouth, sedation, and insomnia.
  c. There are no known food interactions.
  d. The herbal product St. John's wort will enhance the action of the Lexapro.
  e. Taking a glass of wine at bedtime will help him go to sleep.
 
  Why do you think that a drug in the SSRI class was chosen over a tricyclic antidepressant or a
  monoamine oxidase inhibitor (MAOI)?

Question 2

You decide to notify J.B.'s physician about your findings. the attending physician calls in a psychiatrist to evaluate J.B.
 
  Identify two treatments that are available for depression.
 
  Would J.B. be a candidate for electroconvulsive therapy (ECT)? Why or why not?



atrochim

  • Sr. Member
  • ****
  • Posts: 331
Answer to Question 1

Answers: a, b, c
Taking St. John's wort with an SSRI such as Lexapro might increase the risk of serotonin syndrome.
Drinking alcohol with SSRIs might increase sedative effects. Both of these interactions are potentially
dangerous.

Tricyclic antidepressants would be risky, considering J.B.'s history of heart problems. MAOIs are
effective antidepressants. However, these drugs require food restrictions and have the potential
to cause hypertensive crisis; if these food restrictions will not be followed, MAOIs are not the first
choice.

Answer to Question 2

 Antidepressant medications: selective serotonin reuptake inhibitors (SSRIs), tricyclics, and
monoamine oxidase inhibitors (MAOIs)
 Psychotherapy
 Electroconvulsive therapy

Although ECT is successful in many patients with depression and those with suicidal thoughts, ECT
would be very risky for J.B., considering his heart problems and recent heart valve replacement. The
seizure induced by ECT will stress the heart at the onset and for up to 10 minutes afterward.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
 

Did you know?

More than 150,000 Americans killed by cardiovascular disease are younger than the age of 65 years.

Did you know?

Despite claims by manufacturers, the supplement known as Ginkgo biloba was shown in a study of more than 3,000 participants to be ineffective in reducing development of dementia and Alzheimer’s disease in older people.

Did you know?

Addicts to opiates often avoid treatment because they are afraid of withdrawal. Though unpleasant, with proper management, withdrawal is rarely fatal and passes relatively quickly.

Did you know?

Tobacco depletes the body of vitamins A, C, and E, which can result in any of the following: dry hair, dry skin, dry eyes, poor growth, night blindness, abscesses, insomnia, fatigue, reproductive system problems, sinusitis, pneumonia, frequent respiratory problems, skin disorders, weight loss, rickets, osteomalacia, nervousness, muscle spasms, leg cramps, extremity numbness, bone malformations, decayed teeth, difficulty in walking, irritability, restlessness, profuse sweating, increased uric acid (gout), joint damage, damaged red blood cells, destruction of nerves, infertility, miscarriage, and many types of cancer.

Did you know?

Bacteria have been found alive in a lake buried one half mile under ice in Antarctica.

For a complete list of videos, visit our video library