Amitriptyline (Elavil) Nursing Considerations

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Outline

Generic Name

Amitriptyline

Trade Name

Elavil

Indication

Depression, anxiety, insomnia, parkinson’s

Action

Increases effect of serotonin and norepinephrine in the CNS, exhibits anticholinergic effects

Therapeutic Class

Antidepressant

Pharmacologic Class

Tricyclic antidepressant

Nursing Considerations

• Contraindicated in MI, heart failure, QT prolongation, glaucoma
• May increase risk for suicidal ideation
• May cause arrhythmias, hypotension, EKG changes
• May cause alterations in blood glucose levels
• May lead to general sedation and lethargy
• Do not use within 2 weeks of MAOIs
• Instruct pt to take medication exactly as instructed
• Monitor for orthostatic hypotension
• May lead to photosensitivity, instruct patient to use sunscreen
• May turn urine blue/green color.

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Transcript

Hey guys, let’s talk about, amitriptyline also known as Elavil. This is an oral or IV medication seen here in the picture is Endep, which is a brand of amitriptyline. So amitriptyline’s therapeutic class is what the drug does in the body. And this would be an antidepressant more specifically it’s pharmacologic class, or its chemical effect, is it is a tricyclic antidepressant. This type of antidepressant was discovered in the 1950s and it’s named for its three rings of atoms, hence the tri. So amitriptyline works by increasing the effect of serotonin, which increases the feeling of wellbeing in the patient and also norepinephrine and results in anticholinergic effects. So I remember serotonin increases wellbeing. Amitriptyline is used most commonly for depression, anxiety, insomnia, and Parkinson’s disease.

Amitriptyline has some common side effects like lethargy sleepiness, general sedation, dry mouth because of its anticholinergic effects, and even dizziness. Sometimes, guys, patients request a different antidepressant because of this dry mouth side effect. Okay. So some nursing considerations you’re going to want to monitor the patient on amitriptyline for orthostatic hypotension, which is when the patient’s blood pressure drops from the sitting to the standing position. This drug may cause changes in blood sugar, arrhythmias, hypotension, and even create a urine that is blue or green in color. It’s definitely contraindicated in patients with MI glaucoma, heart failure, and who have QT prolongation. And guys amitriptyline comes with a risk of suicidal ideations. Make sure to teach the patient to take this med exactly as prescribed and to use sunscreen because it can cause photosensitivity. So guys tricyclic antidepressants like amitriptyline are older antidepressants, which tend to have more side effects as compared to newer antidepressants. And patients sometimes say they have better results on the newer ones. So I don’t see patients on this medication as much anymore compared to the newer antidepressants. That’s it for amitriptyline or Elavil. Now go out and be your best self today. And as always happy nursing.

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