A patient diagnosed with depression has been taking paroxetine (Paxil) 10mg PO daily for the past month. The patient presents to the clinic with complaints of restlessness and abdominal pain. Which factor does the nurse consider during the assessment?
1. The patient has been taking medication with grapefruit juice at breakfast.
2. The patient is experiencing severe side effects and will be taken off the medication.
3. The patient is taking too much of the drug and is experiencing unexpected side effects.
4. The patient expresses that she is nervous that the side effects will increase with continued use.
Answer: 1
Explanation: Paxil is an SSRI and grapefruit juice may increase the plasma levels, thereby increasing the common side effects of insomnia, early agitation or restlessness, sweating, GI disturbance, weight gain, and sexual side effects. Side effects are minimized by starting at low doses and titrating slowly; the patient is on the lowest dose. Side effects lessen with continued drug use. Abrupt withdrawal or discontinuation is discouraged.
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