ACTIVE LEARNING TEMPLATE:
Medication
William Romero
STUDENT NAME______________________________________
Duloxetine (Cymbalta)
MEDICATION___________________________________________________________________________
REVIEW MODULE CHAPTER____________
CATEGORY CLASS_Serotonin-norepinephrine
______________________________________________________________________
PURPOSE OF MEDICATION
Expected Pharmacological Action
Therapeutic Use
Action SNRIs block reuptake of norepinephrine as
well as serotonin with effects similar to the SSRIs.
Major depression, Generalized anxiety disorder, Social
anxiety disorder, Panic disorder, Pain due to fibromyalgia,
osteoarthritis, low-back pain, diabetic neuropathy
(duloxetine; unlabeled use for venlafaxine)
Complications
Nausea, anorexia, weight loss - Headache, insomnia, anxiety Hypertension, tachycardia - Dizziness, blurred vision - Withdrawal
syndrome - Risk for suicide in children and adolescents - Sexual
dysfunction - Serotonin syndrome - Bronchitis, dyspnea
Medication Administration
PO
Contraindications/Precautions
Contraindications/Precautions - These medications are pregnancy
category risk C. Avoid during the third trimester and avoid breastfeeding
while taking an SNRI. - SNRIs are contraindicated in clients taking
SSRIs, MAOIs, or TCAs. SNRIs need to be discontinued at least 2 weeks
before initiating an MAOI. - Precautions are needed for older adults, and
clients who have bipolar disorder, mania, seizure disorder, recent MI, or
interstitial lung disease
Interactions
Concurrent use with MAO inhibitors may result in serious potentiallyfatal
reactions, may increase the risk of serotonin syndrome, risk of hepatotoxicity
with alcohol use disorder
Nursing Interventions
Monitor closely for notable changes in behavior
that could indicate emergence or worsening of
suicidal thoughts or behavior or depression
Assess for serotonin syndrome
Assess for rash periodically during therapy
Concurrent use with MAO inhibitors may result
in serious potentially fatal reactions, may
increase the risk of serotonin syndrome, risk of
hepatotoxicity with alcohol use disorderIncreased
sense of well-being, renewed interest in
surroundings,
Client Education
Evaluation of Medication Effectiveness
Verbalizing improvement in mood - Increased hopefulness and will to live Ability to perform ADLs - Improved sleeping and eating habits - Increased
interaction with peers
ACTIVE LEARNING TEMPLATES
Instruct clients to continue therapy after
achieving therapeutic effects. Sudden
discontinuation of medication can result
in relapse. - Advise clients to take
medication in the morning to minimize
sleep disturbances. - Advise clients to
take medications with food to minimize
GI disturbances. - Advise clients about
potential sexual side effects. - Avoid use
of MAOIs.
Therapeutic Procedure
A7