Drug Data Generic Name imipramine Trade Name Impril, Nortranil, Novopramine, Tipramine, Tofranil Patients Dose

Classification Therapeutic! !ntidepre""ant" Pharmacologi c Tri#y#li# antidepre""ant" Pregnanc# Categor# C

Mechanism of Action Potentiate" t$e effe#t of "erotonin and norepinep$rine. %a" "ignifi#ant anti#$olinergi# propertie". Pharmaco%ineti cs A! &ell a'"or'ed from t$e (I tra#t. D! &idely di"tri')ted. Pro'a'ly #ro""e" t$e pla#enta and enter" 'rea"t mil*. M&'! +,ten"ively meta'oli-ed 'y t$e liver, mo"tly on fir"t pa"". "ome #onver"ion to a#tive #ompo)nd". /ndergoe" entero$epati# re#ir#)lation and "e#retion into ga"tri# 0)i#e". Onset PO, I 1 $o)r" Pea% PO, I 1 223 4ee*" Duration PO, I 1 4ee*" Drug (alf )ife 5213 $r".

Indication General Indications 6ario)" form" of depre""ion. +n)re"i" in #$ildren. Patients Actual Indication

Contraindications %yper"en"itivity. 7ro""2 "en"itivity 4it$ ot$er antidepre""ant" may o##)r. !ngle2 #lo")re gla)#oma. %yper"en"itivity to tartra-ine or ")lfite" 8in "ome preparation"9. :e#ent I, *no4n $i"tory of ;T# prolongation, $eart fail)re. Precaution Pre2e,i"ting #ardiova"#)lar di"ea"e. <ei-)re" or $i"tory of "ei-)re di"order. ay in#rea"e ri"* of ")i#ide attempt/ideation e"pe#ially d)ring early treatment or do"e ad0)"tment. O=1 >r)g i" pre"ent in 'rea"t mil*. di"#ontin)e imipramine or 'ottle feed. Pedi1 <)i#ide ri"* may 'e greater in #$ildren or adole"#ent". <afety not e"ta'li"$ed in #$ildren ?3 yr. (eri1 (eriatri# patient" 8more ")"#epti'le to adver"e rea#tion"9. (eriatri# male" 4it$ pro"tati# $yperpla"ia are more ")"#epti'le to )rinary retention. .Drug interaction *drug to drug ay #a)"e $ypoten"ion, ta#$y#ardia, and potentially fatal rea#tion" 4$en )"ed 4it$ MAO inhibitors 8avoid #on#)rrent )"e@ di"#ontin)e 2 4* prior to imipramine9. 7on#)rrent )"e 4it$ ++RI antidepressants may re")lt in in#rea"ed to,i#ity and "$o)ld 'e avoided 8fluo"etine "$o)ld 'e "topped 5 4* 'efore9. 7on#)rrent )"e 4it$ clonidine may re")lt in

Adverse Reaction CN+! dro4"ine"", fatig)e, agitation, #onf)"ion, $all)#ination", in"omnia. ''NT! 'l)rred vi"ion, dry eye". C,! !::%AT% I!<, $ypoten"ion, +7( #$ange". GI! #on"tipation, dry mo)t$, na)"ea, paralyti# ile)", 4eig$t gain. G-! )rinary retention, de#rea"ed li'ido. Derm! p$oto"en"itivity. 'ndo! gyne#oma"tia. (emat! 'lood dy"#ra"ia".

Nursing Responsibilities .efore 1. !""e" patientB" diagno"i". 2. !""e"" patientB" mental "tat)". 3. Ta*e 'lood pre"")re and p)l"e rate. C. Ta*e 4eig$t and = I initially. 5. Dor I , p)t amp)le )nder 4arm r)nning 4ater for 1 min to di""olve. During 1. 7onfirm patientB" identity. 2. !dmini"ter medi#ation at t$e rig$t pre"#ri'ed ro)te. 3. (ive oral medi#ation" 4it$ or immediately follo4ing a meal to minimi-e ga"tri# irritation. C. Pra#ti#e a"epti# te#$niE)e. 5. !dmini"ter medi#ation at t$e pre"#ri'ed time. After 1. O'"erve proper do#)mentation of admini"tered medi#ation. 2. +n")re t$at patient $a" f)lly "4allo4ed oral form of medi#ation. 3. O'"erve patientB" 'e$avior #lo"ely for atlea"t 15230 min)te" after admini"tration. C. onitor patientB" 4eig$t and = I t$ro)g$o)t t$erapy. 5. In"tr)#t patient to re"t to de#rea"e ri"* of fall".

Minimum Dose PO IM!100m g/ day Ma"imum Dose PO IM!300m g/ day Contents imipramine Availabilit# and color Tablets! 10 mg, 25 mg, 50 mg, 75 mg. Capsules! 75 mg, 100 mg, 125 mg, 150 mg. In$ection! 12.5 mg/mL Routes of administrat ion PO, I

$yperten"ive #ri"i" and "$o)ld 'e avoided. Imipramine i" meta'oli-ed in t$e liver 'y t$e c#tochrome P/01 2D3 en4#me and it" a#tion may 'e affe#ted 'y dr)g" t$at #ompete for meta'oli"m 'y t$i" en-yme in#l)ding other antidepressants, phenothia4ines, carbama4epine, class 5C antiarrh#thmics 8propafenone, flecainide9. 4$en )"ed #on#)rrently, do"e red)#tion of one or t$e ot$er or 'ot$ may 'e ne#e""ary. +ource!

>eglin, F. et. !l. 200G. >avi"B" >r)g ()ide for N)r"e". 12 t$ ed. D.!. >avi". pp 7032705