AMITRIPTYLINE HYDROCHLORIDE

It is an Anti-Depression drug

1. SUBMITTED BY MR. MILIND DODIYA T.Y.BSC NURSING SUBMITTED TO MS. DHRUVA PATEL NURSING TUTOR AMITRIPTYLINE HYDROCHLORIDE

2. INTRODUCTION Antidepressants are those drugs, which are used for the treatment of depressive illness. These are also called as mood elevators or thymoleptics.

3. DOES & ROUTE OF DRUG ADMINISTRATION Anxiety and insomnia: Orally(Tablets) Out patient: 75mg daily in divided doses, increased to 150mg daily, if needed. In patient: 100mg daily, gradually increased to 300mg daily.

4. GENERAL GUIDELINES DRUG ADMINISTRATION IN PSYCHIATRY Nurses should not administer any drug unless there is a written order. All medications given must be charted on the patient case record sheet.

5. CONTINUE… While giving medication Be sure of patient identification. Do not leave patient until drug is swallowed. Do not permit patient to go to bathroom to take the medication. Do not allow one patient to carry medication to another. Make sure that no patient has access to the drug cupboard. Drug cup bord should be locked when not in use, Never allow a patient or a worker to clean the drug cupboard, and keep safe the keys.

6. MECHANISM OF ACTION Normally, when an impulse reaches adrenergic nerves, the nerves release serotonin and norepinephrine from their storage sites. Some serotonin and norepinephrinereach receptor sites on target tissues. Most of this is taken back into the nerves and stored by the reuptake mechanism, as shown below on the left.

7. CONTINUE…. Amitriptyline blocks serotonin and norepinephrine reuptake by adrenergic nerves. By doing so, it raises serotonin and norepinephrine levels at nerve synapses. This action may elevate mood and reduce depression.

8. INDICATION Depression Anxiety Insomnia Unlabelled uses: Prevention of cluster/ migraine headaches

9. CONTRAINDICATION Acute recovery phase after MI Hypersensitivity to Amitriptyline MAO inhibitor therapy within 14 days

10. SIDE EFFECTS Chills Delusions HTN(Hypertension) Dry mouth Nausea Urine retention Alopecia

11. PHARMACOKINETICS Absorption: well absorbed Distribution: widely distributed; crosses placenta Metabolism: Liver, extensively Excretion: kidneys, breast milk Half-life: 10-46 hr

12. PHARMACODYNAMICS Onset: 45min Peak: 2-12 hr Duration: unknown

13. NURSES RESPONSIBILITY Closely monitor patient with CV disorder because amitriptyline may cause arrhythmias, such as sinus tachycardia. Monitor blood pressure for hypotension or hypertension. Stay alert for behaviour changes, such as hallucination and decreased interest in personal appearance. Abrupt withdrawal after long use may cause nausea, headache, vertigo and nightmares.

14. PATIENT TEACHING Instruct patient to make amitriptyline at bedtime to avoid daytime drowsiness. Instruct patient to avoid using alcohol or OTC drugs that contain alcohol during amitriptyline therapy because alcohol enhances CNS depressant effects.

15. THANK YOU !