Nursing NUR304 Lecture Notes - Lecture 4: Anxiolytic, Antihistamine, Lipophilicity
Document Summary
Choose route based on compliance and preference of patient. Physical examination as indicated and baseline blood work, Commence drug: monitor and manage side effects; monitor efficacy. Some medications (antidepressants, antipsychotics) require a trial of 4-6 weeks or longer to determine efficacy. Titrate for symptom control and tolerability, increase slowly in: Extremes of age (in the elderly may decrease dose by 50% or more) the medication-sensitive the medically ill (aids, hepatic/renal insufficiency) Side effects are often dose-dependent; may be less severe with slower titration; may improve within days. Monitor side effects, repeat scales used for baseline or compare with baseline target symptoms, and blood work as necessary. Discontinue medication slowly (if possible) to minimize withdrawal eg. benzodiazepines after long-term use. Generally five half-lives are required for sage elimination. Rapport, therapeutic alliance and collaborative treatment with patients may improve medication adherence. Psychoeducation to inform the patient about illness, symptoms, risks and benefits of medication.
