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Psychotropic medication dosage and contraindications

Long-Term Care Nursing Advisor, July 12, 2004

The majority of residents in long-term care facilities take at least one psychotropic medication for a behavioral or mood disorder. Since these medications can have serious side effects, especially if given inappropriately, all long-term care nurses must be very familiar with pyschotropic dosing and contraindication information.

Psychotropic medications can cause harmful interactions with many kinds of drugs, including some seizure medications; stomach medications such as cimetidine, ranitidine, or omeprazole; some antibiotics such as erythromycin; antifungal medications such as Diflucan, Sporanox, or Nizoral; or asthma medication. Taking these at the same time with psychotropic drugs may require dose adjustment or special monitoring. Some drug interactions can be fatal.

Special caution: Do not combine MAOIs and SSRIs. A person should not take these drugs within 14 days of each other.

Psychotropic medications are usually given in tablet form. In older people, a low dosage is given since the elderly are especially sensitive to drugs and are unable to tolerate doses given to younger persons. Usually, a dose given in the morning is effective all day. Many antidepressants, antianxiety medicines, and antipsychotics have decreased liver clearance in the elderly, so they stay in the person's system longer.

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