Author Question: A nurse performs a medication history on a newly admitted patient. The patient reports taking ... (Read 71 times)

joblessjake · **on:** Jul 23, 2018

A nurse performs a medication history on a newly admitted patient. The patient reports taking amitriptyline (Elavil) 75 mg at bedtime for 6 weeks to treat depression.

The patient reports having continued fatigue, lack of energy, and depressed mood. The nurse will contact the provider to discuss which intervention?
a. Beginning to taper the amitriptyline
b. Changing to a morning dose schedule
c. Giving the amitriptyline twice daily
d. Increasing the dose of amitriptyline

Question 2

A patient who is taking amitriptyline (Elavil) reports constipation and dry mouth. The nurse will give the patient which instruction?

a. Increase fluid intake.
b. Notify the provider.
c. Request another antidepressant.
d. Stop taking the medication immediately.

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

Answer to Question 1

ANS: A
The response to tricyclic antidepressants (TCAs) should occur after 2 to 4 weeks of therapy. If there is no improvement at this time, the TCA should be gradually withdrawn and an SSRI prescribed. TCAs should never be stopped abruptly. TCAs cause fatigue and drowsiness, so they should be given at bedtime. Changing the dose or the dosing schedule are not indicated.

Answer to Question 2

ANS: A
Constipation and dry mouth are common side effects of tricyclic antidepressants (TCAs), and patients should be taught to manage these symptoms. There is no need to notify the provider or to switch medications unless the side effects become too uncomfortable. Patients should not stop taking TCAs abruptly.