Pediatric Primary Care (147 page)

  Can crush tablet if patient unable to swallow.

   Take at night to decrease oversedation.

   Therapeutic effect may take 1-4 weeks.

  Use sunscreen to prevent photosensitivity.

  Avoid alcohol and other CNS depressants.

  Notify prescriber if pregnant, plan to become pregnant, or are breastfeeding.

  Change position slowly due to orthostatic hypotension.

  Educate parents about FDA concerns of suicide risk in patients on SSRI antidepressants, monitor suicidal risk closely during course of treatment especially in the first 30 days of treatment.

FLUVOXAMINE–SELECTIVE SEROTONIN REUPTAKE INHIBITOR, ANTIDEPRESSANT, ANTIANXIETY

Brand Name

Luvox

Uses

Treat obsessive-compulsive disorder (OCD), major depression, anxiety disorders.

Availability

Tablets: 25 mg, 50 mg, 100 mg.

Indications/Routes/Dosage

Starting dose of 25 mg/day, increase to 50-200 mg/day for children and 150-300 mg/ day for teens.

Adverse Reactions

Headache, drowsiness, dizziness, convulsions, nausea, vomiting, anorexia, constipation, diarrhea, decreased libido, increased effect with St. John's wort. Fatal reactions: MAO inhibitor interactions increase action of propranolol, diazepam, lithium, warfarin, carbamazepine, theophylline.

Implications

  Give with food, milk for GI distress.

  Therapeutic effects may take 2-3 weeks. Use caution when driving.

  Do not use with other CNS depressants, e.g., alcohol, barbiturates, benzodiazepines, St. John's wort.

  Educate parents about FDA concerns of suicide risk in patients on SSRI antidepressants; monitor suicidal risk closely during course of treatment especially in the first 30 days of treatment.

FOLIC ACID–NUTRITION SUPPLEMENT

Brand Name

Folate, Folvite