Medication Management Plan
The medication management plan is said to be a project of the Australian Commission on Quality and Safety in Healthcare (Safetyandquality.gov.au, 2014).
It gives health care providers with a standardized form, which can be applied by pharmacy, nursing and other medical health personnel to develop the information accuracy documented on patient admission and available to the care providers responsible for medicinal decision making.
Before administering Fluoxetine the health care personnel should check if Kate is diabetic or hypertensive. This is because Fluoxetine can create problems with control of blood sugar levels.
Diabetic individuals who are undergoing Fluoxetine treatment may have complications with lower blood sugar levels. A high blood sugar level can commence while the Drug is stopped (Andrews, 2010).
Hence, the respective healthcare personnel should take care of this factor if Kate is diabetic and has anti-diabetes medicines (Sabuncuoglu, Ekıncı & Berkem, 2009).
It is also said that Fluoxetine can change the electrical activity of the heart, and the condition can be severe. This can affect blood flow, or uncontrolled blood pressure.
It sometimes can happen with individuals who are under the treatment of depression and taking Fluoxetine that this medicine affect the blood pressure and also cause antidepressant-induced hypertension.
Fluoxetine is considered as an anti-depressant of the SSRI (Selective Serotonin Reuptake Inhibitor) class (Drugbank.ca, 2014).
Fluoxetine is mainly recommended for the treatment of major depressive disorder, including depression. It is metabolized to norfluoxetine. As an inhibitor, it blocks the serotonin reuptake at the serotonin reuptake pump of the neuronal membrane and increases the serotonin action on 5HT1A autoreceptors.
The inhibitors bind with considerably less affinity to acetylcholine, histamine, and norepinephrine receptors than tricyclic antidepressant medicines, such as Amoxapine and doxepin.
Scientifically, in depressive conditions, there is a functional decrease in amine activity, such as norepinephrine and serotonin. A functional boost of these amines would give rise to mood elevation.
Fluoxetines’ effects are associated with 5HT receptor inhibition, which leads to an amplification of the level of serotonin (Drugbank.ca, 2014).
Antagonisms of histaminergic, muscarinic and α1-adrenergic receptors are linked with different sedative, anticholinergic and cardiovascular effects of TCA medicines.
Fluoxetine attaches with these membrane receptors from the brain tissue much less effectively in vitro than the TCAs (Yi, Liu & Zhai, 2010). In Kate’s case, her main problem is depression. Therefore, it can be said that recommending Kate with Fluoxetine is justified.
The adverse effects of Fluoxetine may include abnormal dreams, anorexia, diarrhea, asthenia, flu syndrome, dry mouth, insomnia, nausea, rash, sinusitis, tremor, vasodilatation, sweating, nervousness and many others.
Fluoxetine is the most stimulating of SSRIs and, hence, is most likely to cause agitation and insomnia, as well as dermatologic reactions like hives, itchiness, or rashes. Various reports have described discontinuation symptoms or severe withdrawal after an unexpected intermission of fluoxetine treatment.
However, studies have also shown that Fluoxetine side effects, like discontinuation, are mild and uncommon, particularly compared to venlafaxine and paroxetine, probably because of this medicine’s comparatively long pharmacological half-life.
In case of unmanageable side effects, the patient should talk to the doctor. It is the doctor’s understanding and responsibility to decide whether to continue with the same medication or not (Mack, 2013). The doctor can otherwise change the dosage or introduce the patient to a slow-release form of the drug.
The patient should consume plenty of water or liquids. This is because route of elimination of this drug is via kidneys. Consumption of plenty of water will help wash and clean the residual metabolites from the kidneys, which can save the system from other adverse effects (Brodziak & Brewczyński, 2013).
In managing the adverse effects of this drug, patients can be advised to eat fewer but frequent meals and slow eating. Low calorie and more fibrous foods should be included in the daily diet plan, like: fruits, vegetables to avoid trans and saturated fats.
To avoid the feeling of tiredness, the patient should suggest taking short nap during day time. Involve self in some kind of physical activity, like morning or evening walk to feel refresh and gain energy in daily activities.
As in the case of Kate, she has two little kids, so treating her mental health condition and resuming her joyful life with her kids are of utmost importance. This is because of her wellbeing and also for the wellbeing of her two little kids.
References
Andrews, L. (2010). Encyclopedia of depression. Santa Barbara, Calif.: Greenwood Press.
Brodziak, A., & Brewczyński, P. (2013). The sequence of adverse life events transforms coping resources. Medical Science Monitor, 19, 1227-1228. doi:10.12659/msm.890118
Drugbank.ca,. (2014). DrugBank: Fluoxetine (DB00472). Retrieved 16 December 2014, from http://www.drugbank.ca/drugs/DB00472
Mack, A. (2013). Suicidal Thoughts and Behavior With Antidepressant Treatment: Reanalysis of the Randomized Placebo-Controlled Studies of Fluoxetine and Venlafaxine. Yearbook Of Psychiatry And Applied Mental Health, 2013, 23-24. doi:10.1016/j.ypsy.2012.08.054
Sabuncuoglu, O., Ekıncı, O., & Berkem, M. (2009). Fluoxetine-induced sleep bruxism in an adolescent treated with buspirone: a case report. Special Care In Dentistry, 29(5), 215-217. doi:10.1111/j.1754-4505.2009.00091.x
Safetyandquality.gov.au,. (2014). National Medication Management Plan | Safety and Quality. Retrieved 16 December 2014, from http://www.safetyandquality.gov.au/our-work/medication-safety/medication-reconciliation/nmmp/
Stone, M., & Hammad, T. (2014). Fluoxetine and suicidal ideation in minor depression. Journal Of Psychiatric Research, 48(1), 131-132. doi:10.1016/j.jpsychires.2013.09.012
Yi, Z., Liu, F., & Zhai, S. (2010). Fluoxetine for the prophylaxis of poststroke depression in patients with stroke: a meta-analysis. International Journal Of Clinical Practice, 64(9), 1310-1317. doi:10.1111/j.1742-1241.2010.02437.x
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