Details About Generic Salt ::  Amoxapin

Main Medicine Class:: Tricyclic antidepressant   

(am-OX-uh-peen)
Asendin
Class: Tricyclic antidepressant

 

Drugs Class ::

 Action Inhibits reuptake of norepinephrine and serotonin in CNS.

Indications for Drugs ::

 Indications Relief of symptoms of depression. Unlabeled use(s): Management of chronic pain associated with migraine, chronic tension headache, diabetic neuropathy, phantom limb pain, tic douloureux, cancer pain, peripheral neuropathy, postherpetic neuralgia, and arthritic pain.

Drug Dose ::

 Route/Dosage

ADULTS: PO Initial dose: 200 to 300 mg/day; may be given in single daily dose at bedtime once effective dosage is established. Divided doses are given for amounts > 300 mg/day. Hospitalized patients refractory to antidepressant therapy and with no history of seizures may be cautiously titrated to 600 mg/day in divided doses.

Maintenance: Single daily dose of £ 300 mg at bedtime. ELDERLY: PO Initially 25 mg bid or tid. If well tolerated, may be increased to 50 mg bid or tid. Some patients may need up to 300 mg/day.

Contraindication ::

 Contraindications Hypersensitivity to tricyclic antidepressants; not recommended for use during acute recovery phase of MI. Drug should not be used concomitantly with MAO inhibitors except under close medical supervision.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Not recommended in children < 16 yr. Neuroleptic malignant syndrome (NMS): Potentially fatal condition that has been reported with amoxapine. Signs and symptoms include hyperpyrexia, muscle rigidity, altered mental status, irregular pulse, irregular blood pressure, tachycardia, and diaphoresis. Notify physician. Discontinue amoxapine and nonessential drugs. Patients switching from MAOI to amoxapine: Wait 7 to 10 days to prevent hypertensive crisis. Special risk patients: Use with caution in patients with history of seizures, urinary retention, urethral or ureteral spasm, angle-closure glaucoma or increased intraocular pressure, cardiovascular disorders, hyperthyroid patients or those patients receiving thyroid medication, hepatic or renal impairment, schizophrenia or paranoia.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

OTHER: Effects can generally be minimized by starting with low doses and increasing gradually. CV: Orthostatic hypotension; hypertension; tachycardia; palpitations; arrhythmias; ECG changes. CNS: Confusion; hallucinations; delusions; nervousness; restlessness; disturbed concentration; decreased memory; agitation; panic; insomnia; nightmares; mania; exacerbation of psychosis; drowsiness; dizziness; weakness; emotional liability; seizures. DERM: Rash; pruritus; photosensitivity reaction; dry skin; acne; itching. EENT: Conjunctivitis; blurred vision; increased intraocular pressure; mydriasis; tinnitus; nasal congestion; peculiar taste in mouth. GI: Nausea; vomiting; anorexia; GI distress; diarrhea; flatulence; dry mouth; constipation. GU: Impotence; sexual dysfunction; nocturia; urinary frequency, retention or hesitancy; urinary tract infection; vaginitis; cystitis. HEMA: Bone marrow depression including agranulocytosis; eosinophilia; purpura; thrombocytopenia; leukopenia. HEPA: Hepatitis; jaundice. META: Elevation or depression of blood glucose levels. RESP: Pharyngitis; rhinitis; sinusitis, cough. OTHER: Numbness; tremors; menstrual irregularities, dysmenorrhea; breast enlargement in males and females; extrapyramidal symptoms (pseudoparkinsonism, movement disorders, akathisia); tardive dyskinesia.

Drug Mode of Action ::  

 Action Inhibits reuptake of norepinephrine and serotonin in CNS.

Drug Interactions ::

 Interactions

Barbiturates, charcoal: May decrease amoxapine blood levels. Cimetidine, fluoxetine: May increase amoxapine blood levels. Clonidine: May result in hypertensive crisis. CNS depressants: Depressant effects may be additive. MAO inhibitors: May cause serious and possibly fatal hypertensive crisis.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any allergies. Note glaucoma, preexisting cardiovascular disease, history of prostatic hypertrophy, and seizures.
  • Restrict amount of drug available to patient during early therapy.
  • Implement suicide precautions.
  • Assist patient to ambulate and change positions to prevent orthostatic hypotension.
  • Offer frequent liquids or oral hygiene.
  • Assess mental status, affect, and suicidal tendencies.
  • Obtain baseline BP and monitor daily.
  • Ensure that baseline hepatic, renal, and pancreatic function tests have been performed before therapy and monitor results during long-term therapy.
  • Review baseline ECG and monitor CBC and differential counts during long-term therapy.
  • Monitor for sedation and initial antidepressant effect during first 4 to 7 days of therapy.
  • Monitor I&O and evaluate bowel elimination.
  • In diabetic patient, monitor blood glucose levels periodically during therapy.
  • Perform baseline and periodic leukocyte and differential counts and liver function studies.

Drug Storage/Management ::

 Administration/Storage

  • Administer by oral route only.
  • Administer with or immediately after meals to reduce GI irritation.
  • May be crushed and given mixed with food or fluid.
  • Dosage is titrated during first week(s). Once effective dosage is determined, may be given as single bedtime dose.
  • Store at room temperature in tightly closed container.

Drug Notes ::

 Patient/Family Education

  • Explain that full effectiveness of drug may not occur for up to 2 to 3 wk after initiation of drug therapy and that dosage will be tapered slowly before stopping.
  • Advise patient that changes in smoking habits can alter drug effectiveness.
  • Instruct patient to monitor food intake; weight gain can occur because of increased appetite and craving for sweets.
  • Emphasize importance of regular dental care because oral dryness can increase risk for dental caries.
  • Instruct patient to report the following symptoms to physician: Persistent dry mouth, constipation, urinary retention, fever, sore throat, or muscle rigidity.
  • Instruct patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs. Suggest patient increase fluids and fiber in diet to alleviate constipation.
  • Instruct patient to avoid intake of alcohol or other CNS depressants.
  • Caution patient to avoid exposure to sunlight, and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
  • Instruct patient not to take otc medications without consulting physician.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

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