Levomilnacipran (Fetzima) Flashcards

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Questions and Answers

What is the classification of Levomilnacipran (Fetzima)?

  • SNRIs (correct)
  • Antidepressant (correct)
  • Cat.C (correct)
  • PO (correct)

What is the indication for Levomilnacipran (Fetzima)?

Major depressive disorders

Levomilnacipran (Fetzima) can cause ______ as a side effect.

serotonin syndrome

Which of the following are side effects of Levomilnacipran (Fetzima)?

<p>Drowsiness (B), Constipation (C), High blood pressure (D)</p> Signup and view all the answers

What is one nursing responsibility when administering Levomilnacipran (Fetzima)?

<p>Monitor for suicidality</p> Signup and view all the answers

What action does Levomilnacipran (Fetzima) have?

<p>Increase serotonin (B), Increase norepinephrine (D)</p> Signup and view all the answers

What condition is Levomilnacipran (Fetzima) contraindicated for?

<p>Alcohol use (A), Narrow angle glaucoma (B), Allergy (C)</p> Signup and view all the answers

Name a caution for the use of Levomilnacipran (Fetzima).

<p>High blood pressure</p> Signup and view all the answers

What drugs can interact with Levomilnacipran (Fetzima)?

<p>MAOIs (A), Triptans (B), Methylene blue (D)</p> Signup and view all the answers

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Study Notes

Levomilnacipran (Fetzima) Overview

  • Levomilnacipran, marketed as Fetzima, is classified as an antidepressant in the SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) category.
  • Administered orally (PO), it is categorized under the prescription category C.

Indication

  • Primarily indicated for the treatment of major depressive disorders.

Side Effects

  • Common side effects may include mania, mydriasis (dilated pupils), hypertension (high blood pressure), hypotension (low blood pressure), gastrointestinal issues such as constipation and vomiting, sexual dysfunction, urinary retention, and low sodium levels.
  • Other potential side effects are hot flushes, skin rash, excessive sweating (hyperhidrosis), inappropriate antidiuretic hormone syndrome, bleeding, serotonin syndrome, and drowsiness.

Nursing Responsibilities

  • Monitor for signs of suicidality and regularly check blood pressure.
  • Advise patients to take the medication at the same time each day.
  • Be vigilant for symptoms of serotonin syndrome, which includes agitation, hallucinations, altered mental status, high heart rate, fluctuating blood pressure, excessive sweating, fever, nausea, vomiting, diarrhea, and muscle stiffness.

Mechanism of Action

  • Levomilnacipran functions by increasing levels of serotonin and norepinephrine in the brain.

Contraindications

  • Contraindicated in patients with a known allergy to the drug, narrow-angle glaucoma, concurrent use of MAOIs (Monoamine Oxidase Inhibitors), and those consuming alcohol.

Cautions

  • Caution is advised in individuals with high blood pressure, cardiovascular disease, cerebrovascular disease, a history of bipolar disorder, and renal impairment.
  • Suicidality should be closely monitored in all patients.

Drug Interactions

  • Concomitant use with MAOIs, methylene blue, or linezolid can lead to serotonin syndrome.
  • Co-administration with triptans, lithium, buspirone, fentanyl, tricyclics, or tramadol poses an increased risk for serotonin syndrome.
  • NSAIDs, aspirin, and warfarin increase the risk of bleeding complications.
  • Antifungal agents like ketoconazole, clarithromycin, or ritonavir can elevate blood levels of levomilnacipran and increase the risk of toxicity.
  • St. John's wort and tryptophan can also induce serotonin syndrome when taken together.

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