Desipramine (Norpramin) Flashcards

Desipramine (Norpramin) Overview

• Desipramine is not considered a first-line treatment option for conditions it addresses.

Drug Classification

• Classified as an antidepressant and falls under Category G (prescription medication).

Indications

• Prescribed for depression, anxiety, and insomnia.

Side Effects

• Common side effects include:
  • Drowsiness and fatigue
  • Blurred vision and dry eyes/mouth
  • Arrhythmias and lower blood pressure
  • Changes in ECG readings
  • Gastrointestinal issues like constipation and paralytic ileus
  • Increased appetite and subsequent weight gain
  • Urinary retention and lowered libido
  • Photosensitivity and elevated blood sugar levels
  • Gynecomastia and blood dyscrasias

Nursing Responsibilities

• Monitor blood pressure and pulse regularly
• Review the patient's cardiovascular history
• Conduct ECG readings and track weight, BMI, and cholesterol levels

Drug Action

• Desipramine enhances the effects of serotonin and norepinephrine in the brain, aiding in mood regulation.

Contraindications

• Should not be used in patients with:
  • Angle-closure glaucoma
  • Heart failure (HF)
  • History of increased QT interval on ECG

Cautions

• Use with caution in patients with cardiovascular disease, prostatic enlargement, or a history of seizures.
• Increased risk of suicidality; weigh benefits against risks in pregnant patients.

Drug Interactions

• Dose adjustments might be necessary when combined with:
  • Other antidepressants, phenothiazines, carbamazepine, and class 1C antiarrhythmics.
• Enzyme inhibitors can elevate drug levels.
• Concurrent use with MAOIs may lead to lower blood pressure, increased heart rate, or fatal reactions.
• SSRIs could cause toxicity.
• Clonidine may cause a hypertensive crisis.
• Phenytoin can enhance desipramine levels.
• May reduce the absorption of levodopa when used together.
• Increased central nervous system depression when used with other depressants inclines a need for careful monitoring.