A client has been prescribed amitriptyline (Elavil) for treatment of depression. The nurse teaches the client to avoid use of over-the-counter sleep aids. What is the nurse's rationale for this advice?
1. Using these drugs in combination often causes bradycardia.
2. Use of amitriptyline can change enzymatic action.
3. Amitriptyline also induces sleep, so additional sleep aids are not needed.
4. Using these two medications together decreases enzyme production in the pancreas, which results in pancreatitis.
2
Rationale 1: The cardiac adverse effect of these drugs is tachycardia.
Rationale 2: Amitriptyline is a tricyclic antidepressant. These drugs can either induce or inhibit the actions of cytochrome P450 enzymes. These changes affect the action of the drugs.
Rationale 3: Amitriptyline can induce sleep, but this is not the nurse's biggest concern regarding co-administration of these medications.
Rationale 4: There is no evidence that using these two drugs together induces pancreatitis.
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