Questions and Answers
What is Nortriptyline (Pamelor) contraindicated in?
Hypersensitivity, angle closure glaucoma, alcohol intolerance.
Nortriptyline (Pamelor) is classified as a ______.
tricyclic antidepressant
What is the therapeutic concentration of Nortriptyline (Pamelor)?
Nortriptyline (Pamelor) may cause fatal reactions with MAOIs.
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What are some indications for using Nortriptyline (Pamelor)?
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Which of the following is a side effect of Nortriptyline (Pamelor)?
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What nursing responsibilities are associated with Nortriptyline (Pamelor)?
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Nortriptyline (Pamelor) may increase the risk of ______.
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Match the following interactions of Nortriptyline (Pamelor) with their effects:
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Nortriptyline (Pamelor) has significant anticholinergic effects.
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What caution should be taken when prescribing Nortriptyline (Pamelor)?
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Study Notes
Nortriptyline (Pamelor) Overview
- Nortriptyline is a tricyclic antidepressant indicated for major depressive disorder, anxiety, insomnia, and neurogenic pain.
- Therapeutic concentration ranges from 50-150 ng/mL, critical for effectiveness without toxicity.
Drug Classification and Category
- Classified as a tricyclic antidepressant under drug category D, indicating potential risks in pregnancy.
- Administered orally (PO).
Side Effects
- Common side effects include drowsiness, fatigue, and lethargy.
- Cognitive disturbances such as confusion and agitation can occur.
- Other notable side effects are dry mouth, blurry vision, arrhythmias, and urinary retention.
- Serious effects include extrapyramidal reactions, hallucinations, and blood dyscrasias.
Nursing Responsibilities
- In geriatric patients, a lower dose is recommended due to increased sensitivity.
- Pediatric safety is not established; higher risk of suicidality noted.
- Regular monitoring necessary for suicidal tendencies, blood pressure, ECG, cardiovascular health, and cholesterol levels.
Mechanism of Action
- Increases the effect of norepinephrine and noradrenaline.
- Possesses a significant anticholinergic effect, relevant for various physiological processes.
Contraindications
- Not to be used in patients with hypersensitivity, angle closure glaucoma, or alcohol intolerance.
- Careful consideration needed before prescribing.
Cautions and Risk Factors
- Use with caution in patients with cardiovascular disease, a history of seizures, asthma, or prostatic hyperplasia.
- Increased risk of suicide attempts noted in susceptible populations.
Drug Interactions
- Potential for fatal reactions when used with MAOIs; can also lead to hypertensive crises when combined with clonidine.
- Decreases therapeutic response to antihypertensives and increases CNS depression when combined with other depressants.
- Interactions may amplify adrenergic effects with vasoconstrictors and exacerbate anticholinergic effects with antihistamines or other antidepressants.
- Blood level elevations can occur with cimetidine, fluoxetine, and hormonal contraceptives.
- Risk of agranulocytosis heightened when used with antithyroid agents or potent anticholinergics like Jimson weed.
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Description
This quiz covers the essential aspects of Nortriptyline, a tricyclic antidepressant used for various conditions such as major depressive disorder and anxiety. It includes information on drug classification, side effects, and nursing responsibilities, particularly in special populations like geriatrics and pediatrics. Test your knowledge on this important medication and its management!
