March 28, 2023

NCLEX Review: Escitalopram (Lexapro) – Mechanism of Action, Uses, Side effects, and Nursing considerations

Hey everyone this is nurse ryan and today we’re going to be talking about the drug acetalopram commonly known by the brand name lexapro you can use the timestamps in the video description to jump ahead essetalopram belongs to the ssri class of antidepressants which stands for selective serotonin reuptake inhibitors before we get into how ssris work we’ll quickly

Review two important topics and the first is serotonin serotonin is a neurotransmitter in the central nervous system that is thought to act as a mood stabilizer it is believed that a low level of serotonin in the brain is linked to the symptoms of depression so again low serotonin is thought to be linked to depression and the second thing to know is the word

Reuptake reuptake is simply a process where a neurotransmitter in our case serotonin is reabsorbed or recycled after it has performed a function now essentially what this does is remove that serotonin from circulating in the central nervous system and the takeaway here is that the more serotonin reuptake occurs the less serotonin is available in the central nervous

System so now how does acetalopram work remember escitaloprem is a selective serotonin reuptake inhibitor so escitalopram inhibits the reuptake of serotonin essentially increasing serotonin levels in the central nervous system and it does so selectively meaning it is expected to increase serotonin levels while having little to no effect on other neurotransmitters

Like norepinephrine for example we do have to keep in mind that all of this stuff about ssris serotonin and depression is not completely understood and that there are definitely gaps in our knowledge of how they work it is very likely that ssris are doing other things in the background that we just don’t know about however esoteloprim can be used for depression

And for a variety of anxiety-related disorders including obsessive-compulsive disorder post-traumatic stress disorder panic disorder and more initial dosing often starts at around 5-10 milligrams per day in healthy adults this can be steadily increased to about 20 milligrams per day ssris have a long list of possible side effects which is common with drugs that

Affect the central nervous system just some of which include nausea diarrhea decreased appetite hyperhidrosis or abnormally excessive sweating and sexual dysfunction other more dangerous side effects include suicidal ideations neuroleptic malignant syndrome or nms and serotonin syndrome nms is a life-threatening reaction which presents as high fever confusion

Tachycardia muscle rigidity and can lead to further complications like rhabdomyolysis kidney failure and seizures serotonin syndrome occurs due to abnormally high levels of serotonin and may present as agitation racing heart rate fever and more severe serotonin syndrome can cause death if it remains untreated there are also many possible interactions with ssris

So we’ll just list a few here ssri use with the maoi drug classification may increase the risk of serotonin syndrome that’s monoamine oxidase inhibitors ssris may increase concentrations of the drug pimazide which may increase the risk for qt prolongation and ventricular arrhythmias ssris may increase the risk for bleeding when used with aspirin nsaids warfarin

And other anticoagulants or antiplatelets and again these are just some of the many possible interactions with ssris it is very important to discontinue maois 14 days prior to starting ssris teach clients to immediately report side effects of ssris to the healthcare provider to achieve the full effectiveness of ssris it may take several weeks of regular dosing

So remind clients to follow the dosing regimen even if symptoms do not improve immediately remember that the mechanism of action of ssris is not fully understood and that it may not be effective for everyone who tries it trial and error is often needed when dealing with mood disorders and as with many medications it is important not to discontinue ssris abruptly

But to instead gradually taper the dose according to the provider’s instructions and that’s about it for the basics of escitalopram if this video has helped you out please consider leaving a like and subscribe i would really appreciate it if you have any questions or would like me to review a specific drug or topic please let me know in the comments and thanks for watching

Transcribed from video
Escitalopram (Lexapro) Nursing Drug Card (Simplified) – Pharmacology By Nurse Ryan