Question

11. Assume that one of your duties in the mental health clinic where you work is to note for each patient any contraindications or potential drug interactions for current medications. You also assist with drug overdose emergencies. Patient A has been diagnosed with major depressive disorder. He's been taking Elavil for several weeks, but it makes him excessively drowsy, so his medication is being changed to an MAO inhibitor. The patient also is taking a prescription decongestant for allergies. What should you note on the patient's chart regarding adverse effects and drug interactions? a. b. Patient B appeared at the clinic suffering from a possible overdose of ithium. She appeared drowsy and complained of dizziness and ringing in her ears. What should be done to elp rid her body of the excess lithium?

Answer 1

11.a.Monoamine oxidase inhibitor are one which breaks down the norepinephrine ,serotonin and dopamine.When it is interrupted it causes increased level of serotonin, doapmine and norepinephrine leading to symptoms.

The adverse effects and the following drug interaction can be noticed in patient's chart are

When drugs like Elavil (amitriptyline,in less than 14 days ) or decongestant are administered it interacts with MAO and take symptoms are

• Tremor (Musculoskeletal )
• Raise in blood pressure (Cardiac) Hypertensive crisis
• Others when more severe
  • Confusion
  • Coma

b.When a patient suffers lithium overdose or toxicity the immediate action is to remove it by hemodialysis or by continuous haemodiafiltration techniques. If not done it will endanger life.

12.a.The person seems to be affected with major depressive disorderin which he may feel depressed.He needs a psychotherapy .

b.The women is suffering adjustment disorder or situational disorder due to the loss of her loved one.Generally people recover grief overtime .If it affects her daily activities then she needs a counselling

13.The following should be included in the medication counselling

• Take orally
• Do not skip(take as soon as remrmbered if near to next dose skip and take the current dose) or overdose
• Report any adverse events immediately
• Drink adequate liquids and add salt as per advice
• Do not stop medication on own which can cause serious recurrence
• No smoking ,alcohol

14.Nardil is an antidepressant. The following food has to be avoided when taking this drug

• Foods high in tyramine (smoked meats,fermented meat)
• Liver,fish
• Dairy products
• No alcohol
• Spoiled food
• Cheese,yogurt