Duloxetine (Cymbalta) Flashcards

Action of Duloxetine (Cymbalta)

• Classified as a serotonin-norepinephrine reuptake inhibitor (SNRI).

Therapeutic Uses for Duloxetine (Cymbalta)

• Effective for major depressive disorder.
• Used in treating neuropathic pain related to diabetic neuropathy.
• Prescribed for generalized anxiety disorder.
• Treats fibromyalgia symptoms.
• Alleviates osteoarthritis pain.

Adverse Effects of Duloxetine (Cymbalta)

• CNS effects may include neuroleptic malignant-like syndrome and seizures.
• Cardiovascular risks include thrombophlebitis and supraventricular dysrhythmia.
• Vision changes noted under EENT.
• Potential for hepatic failure within the gastrointestinal effects.
• Risk of Stevens-Johnson syndrome in integumentary system.
• Systems reactions may include anaphylaxis, angioedema, and serotonin syndrome, characterized by nausea, dizziness, facial flushing, shivering, and sweating.

Contraindications for Duloxetine (Cymbalta)

• Contraindicated in individuals with active alcohol intoxication, alcoholism, or closed-angle glaucoma.
• Not recommended for those with hepatic disease or hypersensitivity to the drug.

Precautions for Duloxetine (Cymbalta)

• Caution advised for use in children.
• Monitor for signs of suicidal ideation.

Nursing Interventions for Duloxetine (Cymbalta)

• Assess mood, sensorium, affect, and risk of suicidal tendencies in patients with depression.
• Monitor blood pressure due to potential for orthostatic hypotension.
• Conduct hepatic studies (e.g., AST, ALT, bilirubin).
• Track weight weekly.
• Recognize signs of dry mouth and withdrawal symptoms including headache and nausea.
• Discuss potential sexual dysfunction with patients.

Client Education for Duloxetine (Cymbalta)

• Inform patients that improvement may be observed in 4-8 weeks or up to 12 weeks in older adults.
• Advise to report any urinary retention.
• Caution against driving or activities requiring alertness until they know how the medication affects them.
• Strongly recommend avoidance of alcohol.
• Stress the importance of not abruptly discontinuing medication after long-term use.
• Highlight the risk of clinical deterioration and suicide risk.
• Advise the use of sunscreen due to photosensitivity.
• Encourage pregnant patients to notify their prescriber.

Therapeutic Response Expected from Duloxetine (Cymbalta)

• Aim for a decrease in symptoms of depression.

Pharmacokinetics of Duloxetine (Cymbalta)

• Well absorbed with 90% protein binding.
• Metabolized by the liver, with approximately 70% of the product recovered in urine.
• Half-life ranges from 9.2 to 19.1 hours.
• Narrow therapeutic index potentially leading to toxic side effects.

Medication Administration for Duloxetine (Cymbalta)

• Must not be broken, crushed, chewed, or sprinkled on food or mixed with liquids.
• Avoid co-administration with St. John's Wort.

Perform/Provide Aspects for Duloxetine (Cymbalta)

• Assist patients with ambulation at the beginning of therapy due to possible drowsiness and dizziness.
• Confirm oral medications are swallowed properly.