Medication Card

Generic name of medication Brand/trade name of medication

sertraline TAB Zoloft

Drug classification (i.e. beta blocker, etc) 1. Patient dose

250 mg, oral
Ther. Class. 2. Safe dose ranges
antidepressants
PO: (Adults) 50 mg/day as a single dose in
Pharm. Class. the morning or evening initially; after several
selective serotonin reuptake inhibitors ssris wk may be ↑ at weekly intervals up to 200
mg/day, depending on response.

PO: (Children 13–17 yr): OCD– 50 mg

once daily.

PO: (Children 6–12 yr): OCD– 25 mg once

daily.

Panic Disorder

PO: (Adults) 25 mg/day initially, may ↑

after 1 wk to 50 mg/day.

PTSD

PO: (Adults) 25 mg once daily for 7 days,

then ↑ to 50 mg once daily; may then be ↑ if
needed at intervals of at least 7 days (range
50–200 mg once daily).

Social Anxiety Disorder

PO: (Adults) 25 mg once daily initially, then

50 mg once daily; may be ↑ at weekly
intervals up to 200 mg/day.

PMDD

PO: (Adults) 50 mg/day initially either daily

or daily during luteal phase of cycle. Daily
dosing may be titrated upward in 50-mg
 increments at the beginning of a cycle. In
luteal phase–only dosing a 50 mg/day
titration step for 3 days at the beginning of
each luteal phase dosing period should be
used (range 50–150 mg/day).

3. Is the dose safe

No

Therapeutic effect (i.e. decreased heart rate, Indication in this patient

etc) and when it should develop
Depression
Therapeutic Effect(s):

 Antidepressant action.
 Decreased incidence of panic attacks.
 Decreased obsessive and compulsive
behavior.
 Decreased feelings of intense fear,
helplessness, or horror.
 Decreased social anxiety.
 Decrease in premenstrual dysphoria.

Pre and post administration assessment Unique nursing considerations

 Assess for suicidal tendencies,  Do not confuse sertraline with

especially during early therapy. Restrict cetirizine or Soriatane (acitretin).
amount of drug available to patient. o Periodically reassess dose and
Risk may be increased in children, continued need for therapy.
adolescents, and adults ≤24 yr. After  PO: Administer as a single dose in
starting therapy, children, adolescents, the morning or evening.
and young adults should be seen by o For oral concentrate, use
health care professional at least weekly dropper provided to remove
for 4 wk, every 3 wk for next 4 wk, and oral concentrate and mix with
on advice of health care professional 4 oz (1/2 cup) of water, ginger
thereafter. ale, lemon/lime soda,
 Monitor appetite and nutritional intake. lemonade or orange juice
Weigh weekly. Notify health care ONLY. Do not mix with other
professional of continued weight loss. liquids. Take immediately
Adjust diet as tolerated to support after mixing. Do not mix in
nutritional status. advance. Slight haze may
appear after mixing; this is
 Assess for serotonin syndrome (mental normal. Dropper dispenser
changes [agitation, hallucinations, contains dry natural rubber,
coma], autonomic instability advise patient with latex
[tachycardia, labile BP, hyperthermia], allergy.
neuromuscular aberrations [hyper-
reflexia, incoordination], and/or GI Contraindicated in:
symptoms [nausea, vomiting,
diarrhea]), especially in patients taking  Hypersensitivity;
other serotonergic drugs (SSRIs,  Concurrent use of MAO inhibitors or
SNRIs, triptans). MAO-like drugs (linezolid or
 Depression: Monitor mood changes. methylene blue);
Inform health care professional if  Concurrent use of pimozide;
patient demonstrates significant  Oral concentrate contains alcohol;
increase in anxiety, nervousness, or avoid in patients with known
insomnia. intolerance.
 Assess for suicidal tendencies,
especially during early therapy. Restrict Use Cautiously in:
amount of drug available to patient.
 OCD: Assess patient for frequency of  Severe hepatic or renal impairment;
obsessive-compulsive behaviors. Note  Patients with a history of mania;
degree to which these thoughts and  History of suicide attempt;
behaviors interfere with daily  Angle-closure glaucoma
functioning.  OB: Use during third trimester may
 Panic Attacks: Assess frequency and result in neonatal serotonin syndrome
severity of panic attacks. requiring prolonged hospitalization,
 PTSD: Assess patient for feelings of respiratory and nutritional support.
fear, helplessness, and horror. Use only if potential benefit justifies
Determine effect on social and potential risk to fetus;
occupational functioning.  Lactation: May cause sedation in
 Social Anxiety Disorder: Assess infant; discontinue drug or bottle-
patient for symptoms of social anxiety feed;
disorder (blushing, sweating, trembling,  Pedi: May ↑ risk of suicide
tachycardia during interactions with attempt/ideation especially during
new people, people in authority, or early treatment or dose adjustment;
groups) periodically during therapy. risk may be greater in children or
 Premenstrual Dysphoric Disorder: adolescents.
Assess patient for symptoms of
premenstrual dysphoric disorder
(feeling angry, tense, or tired; crying
easily, feeling sad or hopeless; arguing
with family or friends for no reason;
difficulty sleeping or paying attention;
feeling out of control or unable to cope;
having cramping, bloating, food
 craving, or breast tenderness)
periodically during therapy.

Lab Test Considerations: May cause false-

positive urine screening tests for
benzodiazepines.

 May cause hyperglycemia and diabetes

mellitus; monitor serum glucose if
clinical symptoms occur.

Adverse effects/minimizing discomfort and Key patient teaching points

harm
 Instruct patient to take sertraline as
CNS: SUICIDAL THOUGHTS, dizziness, directed. Take missed doses as soon
drowsiness, fatigue, headache, insomnia, as possible and return to regular
agitation, anxiety, confusion, emotional dosing schedule. Do not double
lability, impaired concentration, manic doses. Do not stop abruptly; may
reaction, nervousness, weakness, yawning cause dysphoric mood, irritability,
agitation, dizziness, sensory
EENT: pharyngitis, rhinitis, tinnitus, visual disturbances (paresthesias such as
abnormalities electric shock sensations), anxiety,
confusion, headache, lethargy,
CV: chest pain, palpitations emotional lability, insomnia, and
hypomania.
GI: diarrhea, dry mouth, nausea, abdominal  May cause drowsiness or dizziness.
pain, altered taste, anorexia, constipation, Caution patient to avoid driving and
dyspepsia, flatulence, ↑ appetite, vomiting other activities requiring alertness
until response to the drug is known.
GU: sexual dysfunction, menstrual disorders,  Advise patient, family, and caregivers
urinary disorders, urinary frequency to look for suicidality, especially
during early therapy or dose changes.
Derm: ↑ sweating, hot flashes, rash Notify health care professional
immediately if thoughts about suicide
Endo: diabetes or dying, attempts to commit suicide;
new or worse depression or anxiety;
F and E: hyponatremia agitation or restlessness; panic
attacks; insomnia; new or worse
MS: back pain, myalgia irritability, aggressiveness, acting on
dangerous impulses, mania, or other
Neuro: tremor, hypertonia, hypoesthesia, changes in mood or behavior or if
paresthesia, twitching symptoms of serotonin syndrome
occur.
Misc: SEROTONIN SYNDROME, fever,  Advise patient to avoid alcohol or
thirst other CNS depressant drugs during
therapy and to consult with health
* CAPITALS indicate life-threatening. care professional before taking other
medications and to avoid alcohol or
other CNS depressant drugs during
therapy.
 Instruct patient to notify health care
professional of all Rx or OTC
medications, vitamins, or herbal
products being taken and consult
health care professional before taking
any new medications, especially St.
John's wort or SAMe.
 Inform patient that frequent mouth
rinses, good oral hygiene, and
sugarless gum or candy may
minimize dry mouth. If dry mouth
persists for more than 2 wk, consult
health care professional regarding use
of saliva substitute.
 Advise patient to wear sunscreen and
protective clothing to prevent
photosensitivity reactions.
 Advise patient to notify health care
professional if headache, weakness,
nausea, anorexia, anxiety, or
insomnia persists.
 Instruct female patient to inform
health care professional if pregnancy
is planned or suspected or if breast
feeding.
 Emphasize the importance of follow-
up exams to monitor progress.
Encourage patient participation in
psychotherapy to improve coping
skills.