Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency

escitalopram Lexapro Antidepressant 10 mg po QD
Peak Onset Duration Normal dosage range
unknown 1-4 wk unknown 10-20 mg once daily
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
depression N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Selectively inhibits the reuptake of serotonin in the CNS. Anti Hypersensitivity
depressant action
Common side effects
Insomnia, diarrhea, nausea, dizziness, drowsiness, fatigue

Lexapro (escitalopram oxalate)

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) None significant
Darvocet: Sedatives, tranquilizers, muscle relaxants,
antidepressants, and other central nervous system (CNS) Be sure to teach the patient the following about this medication
depressants may have additive CNS- and/or respiratory- Do not stop abruptly, do not double dose, avoid alcohol and other
depressant effects with propoxyphene. Misuse of propoxyphene, CNS depressants
either alone or in combination with other CNS depressants, has
been a major cause of drug-related deaths, particularly in patients
with a history of emotional disturbances, suicidal ideation, or
alcohol and drug abuse. In a large Canadian study, propoxyphene
use was also associated with a 60% increased risk of hip fracture
in the elderly, and the risk was further increased by concomitant
use of psychotropic agents (sedatives, antidepressants,
neuroleptics), presumably due to additive psychomotor
impairment. Therefore, these drugs may constitute a dangerous
combination in certain susceptible populations.
Reglan: Coadministration of metoclopramide with the serotonin
reuptake inhibitors, sertraline and venlafaxine, has been
associated with development of the serotonin syndrome and
severe extrapyramidal reactions.
Morphine, Restoril, Phenergan: Central nervous system-
and/or respiratory-depressant effects may be additively or
synergistically increased in patients taking multiple drugs that
cause these effects, especially in elderly or debilitated patients.
Percocet: A case report suggests that use of serotonin reuptake
inhibitors with oxycodone may potentiate the risk of serotonin
syndrome, which is a rare but serious and potentially fatal
condition thought to result from hyperstimulation of brainstem 5-
HT1A receptors. However, unlike other analgesics such as
phenylpiperidine opioids (e.g., meperidine) and tramadol,
oxycodone is not known to possess serotonergic activity and has
not previously been associated with the serotonin syndrome.
Lisinopril: Many psychotherapeutic and CNS-active agents
(e.g., anxiolytics, sedatives, hypnotics, antidepressants,
antipsychotics, opioids, alcohol, muscle relaxants) exhibit
hypotensive effects, especially during initiation of therapy and
dose escalation. Coadministration with antihypertensive agents,
in particular vasodilators and alpha-blockers, may result in
additive effects on blood pressure and orthostasis.
Lovenox: Serotonin reuptake inhibitors may potentiate the risk
of bleeding in patients receiving heparin therapy. The exact
mechanism is unknown but may involve a pharmacodynamic
interaction, as serotonin reuptake inhibitors have been reported to
interfere with platelet function.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
monitor mood changes and level of anxiety Increases sense of well being,
assess for suicidal tendencies Suicidal statements or mood changes renewed interest in
surroundings. May take 1-4
weeks

Lexapro (escitalopram oxalate)