March 28, 2023

And september 14th 1998 okay so i’m gonna discuss your prescription with you before discharge all right so we give you a pamphlet english okay yeah okay so here’s the pamphlet alright we’re gonna go out we’re gonna go over it together okay okay i just want to ask you some questions before we start sunbae yeah it’s funny you said english is your primary language yeah

That sounds good okay great do you have a preferred method of learning by reading by hearing i don’t usually just read alright so thank you for answering my questions okay so why don’t you tell me what you already know about your medication all i know is that i’m taking prozac for my depression that’s all okay so as you can see here in the pamphlet is a prozac is

The brand name of the medication that generic name is fluoxetine so it’s part of a group of antidepressants are called ssris okay um what exactly are ssris so there’s selective serotonin reuptake inhibitors they work by blocking then around all the uptake of serotonin which is a mono i mean neurotransmitter as a result of reuptake blockade this concentration of the

Model i mean neurotransmitter increases this mechanism is consistent with the theory that depressions thanks for the efficiency of auto iv mediated transmission that’s where you prescribe prozac there’s drug intensifies pottawattamie effect okay i think i’m beginning to understand why i need this medication alright that’s great do you have any other questions about

Poison uh yes how do i take the medication okay so they’re going to be none single as a single dose in the morning then the future your doses is going to be increased and you’re going to take two doses one in the morning i want so you always take your medications as their doctor though if you miss your dose then just take it as soon as you remember unless it’s

Almost time for your next dose which then you’re just going to take that next dose soon keep on schedule okay i’m so i’m only taking 20 milligrams prozac and my friend hasn’t seen medication and she’s taking 60 milligrams so why is my go so low so well the initial dosage for depression starts at 20 milligrams a day if needed the doses can be gradually increased

And you can go to a maximum 80 milligrams a day but it should generally be avoided due to increased adverse effects like without increasing benefits um what do you mean by adverse effects so they can be mild moderate or severe they’re just unexpected medical problems that they heard during treatment with a drug this prozac have any adverse effects yeah it has

Adverse effects some include sexual dysfunction weight gain serotonin syndrome we draw a syndrome neonatal effects from recent pregnancy extrapyramidal side effects bruxism bleeding disorders hyponatremia and may increase the risk of suicide in depressed patients a lot to take in do you mind explaining like what start twenties syndrome is withdrawal syndrome

Extrapyramidal side effects and makeover date really i mean of course i recommend you write this information down right on the pamphlet thank you so that you have a good future all right you ready yes okay so i’m gonna start with the adversative serotonin syndrome medicinal usually begins between two to 72 hours after treatment so the signs and symptoms include

Agitation confusion anxiety hallucination and poor concentration as well as in coordination and tremors and fever how does this happen this happens with the concurrent use of mao inhibitors and other drugs such as tram doll and linezolid i will make sure to give you a proper list before you’re discharged thank you this is very feminine no problem it’s a more

For business to know about adverse effects that medications can cause open to need to tell you about other adverse effects withdrawal syndrome is another adverse effect of ssris this happens with abrupt discontinuation of ssris symptoms include dizziness nausea headache and tremors and when with these symptoms begin they begin within days to weeks and lost those

And they persist for one to three weeks and how can withdrawal syndrome be minimized so i can do minimize minimize by tapering the dosage slowly it’s least likely to call which caused a withdrawal reaction but it’s still important to be informed about it okay yeah i like to know a lot of information about these medications that i’m taking what our extrapyramidal

Side effects so among patients that take ssris the most common of the extra primal side effects or eps is akathisia which is characterized by restlessness and agitation okay i’ll make sure to look out for these symptoms what is hyponatremia v livanov training is when the sodium serum is below 135 which is the norm and symptoms include dizziness fatigue headache

Confusion irritability or as it can cause low sodium levels which is why sodium should be measured at baseline and periodically thereafter got it so use of this medication also cause a sexual dysfunction what do you mean by that yeah so it causes decreased sexual and has about 70 percent of men and women what i’ve been able to manage it yeah it can be managed in

Several ways in some cases reducing the dosage or discontinuing the medications on fridays and saturdays can help another solution is to add a drug that can overcome the problem i’m kind of drug you can use boosts perón and two typical antidepressants which are appropriate and natha’s odom and what do i do these adverse effects occur so if you begin to notice

Any symptoms of the adverse effects halls here at the office we will make an appointment to adjust your medication dosage or if we believe that adverse effects to be severe we may redirect you to a local hospital a good idea would be to keep our offices number on your speed dial in case you need to report any signs of the adverse effects that took an idea was what do

You take any natural remedies at home yes i do i take st. john’s work to help with my depression why well saint john’s wort increases the risk of serotonin syndrome when taken alongside philosophy so we’ll discuss the best way to discontinue that supplement prior to beginning your new prescription of philosophy i didn’t realize the natural remedy had such a large

Effect to medicate on my medication my family uses them all the time i was have issues in the past well one while natural remedies are common they should be discussed with your doctor because like all other substances they do affect the body and they can interact interact with your medications so in the future when filling out your at-home medication list always

Be sure to mention what natural remedies and supplements you take ok that’s really helpful note for the future there are kind of a pretty good understanding of the medication ok so how about you need a review of the things we discussed and i can fill in any holes i notice ok well so far i know that i’m taking prozac rockstein i’m 20-mile advantage to my depression

It’s also known by the name as prozac it’s an ssri so it works by blocking serotonin in the brain i’ll take my pill and morning every day the address on reactions we discussed with serotonin syndrome withdrawal syndrome extrapyramidal side effects hyponatremia and sexual dysfunction and then what is the symptoms of any of these i should call the office and come

In to see my doctor i’ll also be talking to my doctor regarding stopping my use of st. john’s wort to prevent serotonin syndrome that’s perfect now let’s discuss your appointment schedule before you leave and then i’ll have the doctor come in you need to come and more frequently to be assessed for increased suicidal ideation as we monitor your early response to

The medication ok that sounds good to me so i see you work monday through friday how about saturday appointment work for you saturday morning would be perfect that we can do so we will be scheduling scheduling weekly appointments for one month then an appointment three weeks after that from there we will schedule based on the advice of your health care provider

Ok that works great for me wonderful before i go and send the doctor in i’m gonna have you sign a form stating you received education on this new medication and a handout in your preferred language feel free to look over it before you sign ok

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