Imipramine, Fluoxetine and Carbamazepine

IMIPRAMINE

Its mechanism of action makes it the least sedative tricyclic antidepressant. They prevent the CNS's noradrenaline neurons from reabsorbing it. Similarly, it prevents serotonin from being reabsorbed (5- HT). Antidepressant activity is linked to the inhibition of this monoamine neurotransmitter's reuptake, which amplifies their impact in the brain.

Indication

• Different types of depression
• Analgesic for some types of neuropathic and chronic pain
• Incontinence in children

Dose

• Adult: Up to 75mg per day in divided doses at first, then 150–200mg per day.
• Child: It is typically not advised for kids.

Contraindication:

• Severe liver illness, porphyria, recent myocardial infarction, manic phase of bipolar disorder, narrow angle glaucoma, pregnancy, lactation, arrhythmias,

Side Effect:

• Sedation,
• Sleepiness,
• Trembling,
• Coma,
• Seizure,
• Anxiety,
• Disorientation,
• Tachycardia,
• Arrhythmias,
• Hypotension,
• Blurred vision,
• Weakness,
• Dry mouth,
• Nausea,
• Vomiting,
• Epigastric distress, 
• Paralytic ileus, 
• Hepatitis,
• Increased hunger,
• Urine retention, 
• Blood dyscrasias.

Nursing Consideration

• The It has a mediocre antimuscarinic effect.
• It shouldn't be administered along with alcohol and phenobarbitone (most antipsychotic medications).
• Dry mouth and urine retention could be brought on by the medication. Consult with doctors if patients complain of allergies. drinking water is therefore necessary.
• Patients may experience sleepiness. so encourage patients to use the machinery at work
• It is advised that nurses periodically take the vital signs. It might result in hypotension.
• Additionally helpful for neurogenic pain, the medication shouldn't be abruptly stopped using.

FLUOXETINE

It is a brand-new oral antidepressant medication.

Mechanism of Action

• It specifically prevents serotonin reuptake. These drugs, known as selective serotonin uptake inhibitors, seem to work well as antidepressants.

Indication

• A depressive disorder, Anorexia nervosa (eating and purging activity)
• Disorder of compulsive behavior

Dose

• Adults: 20 mg first thing in the morning, and then up to 40 mg as needed.
  Child: It is not advised to have children.

Contraindication

• Patients with manic episodes, kids

Side Effect:

• Rash, itching, chills, increased appetite, weight loss, agitation, sexual dysfunction, visual disturbance, photosensitivity, sucidal ideation, bronchitis, rhinitis.

Nursing Consideration

• Tell patients not to take this medication in the afternoon because it can make them jittery and even sleepy.
• Tryptophan-containing foods such meats, poultry, fish, liver, kidneys, eggs, nuts, etc., must be avoided.
• Give a thorough explanation of all potential side effects and urge the patient to report anything out of the ordinary.

CARBAMAZEPINE

It has antiepileptic properties comparable to phenytoin.

Mechanism of Action

• By obstructing sodium channels in nerve membranes, it seems to work.
• This lessens the excitability of nerve cells and stops the spread of abnormal brain discharge.

Indication:

• Prevention of all-encompassing tonic-clonic
• Alleviate diabetic neuropathy or trigeminal neuralgia discomfort.
• Seizure disorders that are partial (especially complex partial), mixed partial, or generalized.
• Bipolar illnesses

Dose:

• Adult: Initially 100mg at night for 3 days, then dose can be gradually increased up to 800mg to 1200mg/day in divided dose
• Maximum dose: 2000mg / d * ay
• Trigeminal neuralgia: 100mg daily or bid
• Usual range: 200mg per dose.

Contraindication:

• Depressed bone marrow, pregnancy, and porphyria

Adverse Effect:

• Drowsiness, ataxia, vertigo, slurred speech, sedation, sedation, dizziness. fatigue, slurred speech, CCF. syncope, hypertension or hypotension, oedema, hesitacy, urinary retention. hyponatremia, hepatitis, elevated liver enzyms, aplastic anaemia, neutropenia, nystagmus, diplopia.

Nursing Consideration

• It is advised that nurses note hypersensitivity.
• Depressed bone marrow may result from it.
• If there is a lot of bone marrow depression, stop.
• Could lead to psychosis
• Making oral contraceptive pills ineffective
• Associated with bradycardia and hypotension
• Avoid using simple analgesics to treat minor aches and pains.