Fluoxetine
Fluoxetine
Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities
Generic Name Therapeutic: Selectively inhibits the reuptake General Indications CNS: NEUROLEPTIC Before
fluoxetine antidepressants of serotonin in the CNS. Hypersensitivity; Concurrent MALIGNANT SYNDROME, 1. Assess patient’s mood.
Major depressive disorder. use or use within 14 days of SEIZURES, SUICIDAL 2. Assess patient’s mental status.
Trade Name Pharmacologic Pharmacokinetics Obsessive compulsive discontinuing MAO inhibitors THOUGHTS, anxiety, 3. Assess if patient had any past
Prozac, Sarafem Selective serotonin A: Well absorbed after oral (fluoxetine should be drowsiness, headache, suicidal tendencies.
disorder (OCD). Bulimia
reuptake inhibitors(SSRIs) administration. discontinued at least 5 wk insomnia, nervousness, 4. Confirm medication from
nervosa. Panic disorder.
D: Crosses the blood-brain Depressive episodes before MAO therapy is abnormal dreams, dizziness, doctor’s orders.
Pregnancy Category barrier. associated with bipolar I initiated); Concurrent use of fatigue, hypomania, mania, 5. Assess patient for sensitivity
Patients Dose pimozide; Concurrent use of weakness. reaction to medication.
B disorder (when used with
M&E: Converted by the olanzapine). Treatment thioridazine (fluoxetine should EENT: stuffy nose, visual
liver to norfluoxetine (primarily resistant depression (when be discontinued at least 5 wk disturbances. During
by CYP2D6 isoenzyme), another used with olanzapine). before thioridazine therapy is Resp: cough.
antidepressant compound; the initiated). CV: chest pain, palpitations.
Minimum Dose Sarafem: Premenstrual 1. Confirm patient’s identity.
CYP2D6 enzyme system GI: diarrhea, abdominal pain,
PO:5mg/day dysphoric disorder 2. May administer mediation
exhibits genetic
(PMDD). Precaution abnormal taste, anorexia,
polymorphism (_7% of Severe hepatic or renal with food to reduce GI
Unlabeled Use: Anorexia constipation, dry mouth,
population may be poor impairment (lower/less irritation.
nervosa: ADHD, Diabetic dyspepsia, nausea, vomiting,
metabolizers and may have frequent dose may be 3. Do not go over the
Maximum Dose neuropathy, Fibromyalgia, weight loss.
significantly increase fluoxetine necessary); History of recommended dose.
PO:80mg/day Obesity, Raynaud’s GU: sexual dysfunction, 4. Practice aseptic technique.
concentrations and an increased seizures; Debilitated patients urinary frequency.
phenomenon, Social 5. Do not crush or open ER
risk of adverse effects). (increased risk of seizures); Derm:qsweating, pruritus,
Contents anxiety disorder (social preparations.
Fluoxetine and norfluoxetine are Diabetes mellitus; Patients erythema nodusum, flushing,
fluoxetine phobia), Post-traumatic
mostly with concurrent chronic illness rashes.
stress disorder (PTSD).
metabolized by the liver; 12% or multiple drug therapy (dose After
Endo: dysmenorrhea.
Availability and excreted by kidneys adjustments may be
Patients Actual F and E: hyponatremia.
color as unchanged fluoxetine, 7% as necessary); Patients with
Indication MS: arthralgia, back pain, 1. Observe proper documentation
Tablets: 10 mg, 20 unchanged norfluoxetine. impaired hepatic function
myalgia. of administered medication.
mg. ( decrease doses/ increase 2. Ensure that patient has fully
Onset Neuro: tremor.
Capsules: 10 mg, 20 dosing interval may be swallowed oral form of
necessary); May increase risk Misc: SEROTONIN
mg, 40 mg. medication.
1-4wks of suicide attempt/ideation SYNDROME, allergic
Delayed- release 3. Observe patient’s behavior
Peak especially during early reactions, fever, flu-like
capsules (Prozac closely for atleast 15-30
unknown treatment or dose adjustment; syndrome, hot flashes,
Weekly): 90 mg. minutes after administration.
sensitivity reaction.
Oral solution (mint OB: Use during third 4. Instruct patient to move
flavor):20 mg/5 mL. Duration trimester may result in slowly to prevent dizziness.
2wks neonatal serotonin syndrome 5. Instruct patient to rest to
Routes of requiring prolonged decrease risk of falls.
administration hospitalization, respiratory
Drug Half Life and nutritional support. May
1-3 days cause sedation in infant;
PO
Lactation: May cause sedation
in infant; discontinue drug or
bottle-feed;
Pedi: Risk of suicide ideation
or attempt may be greater in
children or adolescents (safe
use in children < 8 yr not
established);
Geri: Appears on Beers list.
Geriatric patients are at high
risk for excessive CNS
stimulation, sleep
disturbances, and agitation.
.Drug interaction
-drug to drug