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NURS 5: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Venlafaxine

Peak 2-4 wk Trade Name Effexor XR Onset Within 2 wk Classification antidepressants, antianxiety agents Dose 75 mg 150mg Route PO Time/frequency Every AM 830

Duration unknown

Why is your patient getting this medication Major depressive illness or relapse, often in conjunction with psychotherapy, Generalized anxiety disorder (Effexor XR only), Social anxiety disorder (Effexor XR only) Mechanism of action and indications Nursing Implications (what to focus on) (Why med ordered) Contraindications/warnings/interactions Inhibits serotonin and norepinephrine reuptake in the Hypersensitivity, CNS Hepatic impairment ( dose recommended) History of seizures, History of drug abuse Common side effects abnormal dreams, anxiety, dizziness, headache, insomnia, nervousness, weakness, rhinitis, visual disturbances, abdominal pain, altered taste, anorexia, constipation, diarrhea, dry mouth, dyspepsia, nausea, vomiting, weight loss, sexual dysfunction, ecchymoses, paresthesia, chills Interactions with other patient drugs, OTC or Lab value alterations caused by medicine herbal medicines (ask patient specifically) Monitor CBC with differential and platelet count Concurrent use with alcohol or other CNS periodically during therapy. May cause anemia, depressants, including sedative/hypnotics,and leukocytosis, leukopenia, thrombocytopenia, basophilia, opioid analgesics, in depressed patients is not and eosinophilia, recommended, May cause an in serum alkaline phosphatase, bilirubin, AST, ALT, BUN, and creatinine, May also cause serum cholesterol, May cause electrolyte abnormalities (hyperglycemia or hypoglycemia, hyperkalemia or hypokalemia, hyperuricemia, hyperphosphatemia or hypophosphatemia, and hyponatremia) Be sure to teach the patient the following about this medication Instruct patient to take medication exactly as directed at the same time each day. Take missed doses as soon as possible unless almost time for next dose. Do not double doses or discontinue abruptly. Patients taking venlafaxine for >6 wk should have dose gradually decreased before

Normal dosage range Extended-release (XR) capsules--75 mg once daily (some patients may be started at 37.5 mg once daily) for 4-7 days; doses may then be increased at intervals of not less than 4 days up to 225 mg/day For IV meds, compatibility with IV drips and/or solutions NA

discontinuation. Extended-release capsules should be swallowed whole; do not crush, break, or chew May cause drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertness until response to the drug is known. Caution patient to avoid taking alcohol or other CNS-depressant drugs during therapy and not to take other Rx, OTC, or herbal products without consulting health care professional. Instruct patient to notify health care professional if signs of allergy (rash, hives) occur. Emphasize the importance of follow-up exams to monitor progress. Encourage patient participation in psychotherapy Nursing Process- Assessment Assessment Evaluation (Pre-administration assessment) Why would you hold or not give this Check after giving Assess mental status and mood changes. med? Increased sense of wellInform physician or other health care signs of allergy (rash, hives) occur being, professional if patient demonstrates Renewed interest in significant increase in anxiety, surroundings. Need for nervousness, or insomnia, Assess suicidal therapy should be tendencies, especially in early therapy. periodically reassessed. Restrict amount of drug available to Therapy is usually patient, Monitor blood pressure before continued for several and periodically during therapy. Sustained months. hypertension may be dose related; Decreased decrease dose or discontinue therapy if anxiety this occurs, Monitor appetite and nutritional intake. Weigh weekly. Report continued weight loss. Adjust diet as tolerated to support nutritional status