Imipramine Overview and Pharmacology

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Questions and Answers

What is the therapeutic class for imipramine?

Anti-depressant

What is the drug class for imipramine?

Tricyclic Antidepressant

What are the indications for imipramine?

Schizophrenia; short-term treatment of acute mania or mixed episodes associated with bipolar disorder, various forms of depression, enuresis in children

What are the pharmacodynamics for imipramine?

<p>Blocks the reuptake of norepinephrine and serotonin; blocks acetylcholine receptors</p> Signup and view all the answers

Where is imipramine distributed?

<p>Crosses the placenta; enters the breast milk</p> Signup and view all the answers

Where is imipramine metabolized?

<p>Liver (CYP) into the active metabolite desipramine</p> Signup and view all the answers

Where is imipramine excreted?

<p>Renal; small amounts in the bile and feces</p> Signup and view all the answers

What would you assess for imipramine?

<p>Assess weight and Body Mass Index (BMI), assess for sexual dysfunction, assess for suicidal tendencies, assess blood pressure and pulse prior to administration, include orthostatic hypertension as part of vital signs during initial treatment period</p> Signup and view all the answers

What labs would you obtain for imipramine?

<p>Complete blood count with differential (CBC w/diff); blood glucose</p> Signup and view all the answers

What are the implementations for imipramine?

<p>Administer with food; nighttime administration preferred</p> Signup and view all the answers

What would you evaluate for imipramine?

<p>Increased sense of well-being, renewed interest in surroundings, improved energy level, decrease in nocturnal enuresis episodes</p> Signup and view all the answers

What are the side effects/adverse reactions for imipramine?

<p>Drowsiness, fatigue, blurred vision, dry eyes, hypotension, seizures, suicidal ideation, constipation, dry mouth, decreased libido, arrhythmias</p> Signup and view all the answers

What are the patient family teachings for imipramine?

<p>Advise patient that it takes 2 weeks or longer until full therapeutic effects are achieved, risk of increased suicidal ideation during initial therapy, caution to avoid activities requiring alertness until effects are known, notify prescriber if visual changes occur, caution to use sunscreen, urine may turn blue-green, avoid alcohol or other CNS depressants</p> Signup and view all the answers

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Study Notes

Imipramine Overview

  • Therapeutic class: Anti-depressant
  • Drug class: Tricyclic Antidepressant

Indications

  • Used for schizophrenia and short-term treatment of acute mania or mixed episodes in bipolar disorder
  • Addresses various forms of depression
  • Effective for enuresis (bedwetting) in children

Pharmacodynamics

  • Inhibits the reuptake of norepinephrine and serotonin
  • Blocks acetylcholine receptors

Distribution

  • Crosses the placenta, posing risks during pregnancy
  • Present in breast milk, affecting nursing infants

Metabolism

  • Metabolized in the liver through CYP enzymes into the active metabolite desipramine

Excretion

  • Primarily excreted renally; small amounts found in bile and feces

Assessment Considerations

  • Monitor weight and Body Mass Index (BMI)
  • Evaluate sexual dysfunction and suicidal tendencies, especially during initiation phase
  • Check blood pressure and pulse prior to administration, including orthostatic hypotension

Laboratory Tests

  • Complete blood count with differential (CBC w/diff)
  • Blood glucose levels

Administration Implementation

  • Administer with food; night-time doses preferred to reduce daytime drowsiness

Evaluation of Effectiveness

  • Look for increased sense of well-being and renewed interest in surroundings
  • Improved energy levels and a decrease in nocturnal enuresis episodes

Side Effects and Adverse Reactions

  • Common: drowsiness, fatigue, blurred vision, dry eyes
  • Serious: hypotension, seizures, suicidal ideation, constipation, dry mouth, decreased libido, arrhythmias

Patient and Family Education

  • Full therapeutic effects may take 2 weeks or more to develop
  • Increased risk of suicidal ideation during initial therapy
  • Advise caution with activities requiring alertness until medication effects are known
  • Report any visual changes to prescriber
  • Use sunscreen and protective clothing to avoid photosensitivity
  • Urine may turn blue-green in color as a benign side effect
  • Avoid alcohol and CNS depressants to minimize risks

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