| 单词 | prozac | |||
| 释义 | ProzacPro·zacP0625650 (prō′zăk′)Prozac(ˈprəʊzæk)Pro•zac(ˈproʊ zæk)Trademark.
ProzacProzac,trade name for fluoxetine hydrochloride. See antidepressantantidepressant,any of a wide range of drugs used to treat psychic depression. They are given to elevate mood, counter suicidal thoughts, and increase the effectiveness of psychotherapy. ..... Click the link for more information. . ProzacProzacProzac[pro´zak]fluoxetine hydrochloridePharmacologic class: Selective serotonin reuptake inhibitor Therapeutic class: Antidepressant Pregnancy risk category B ActionSelectively inhibits serotonin reuptake in CNS; has little to no effect on norepinephrine and dopamine reuptake AvailabilityCapsules: 10 mg, 15 mg, 20 mg, 40 mg Capsules (delayed-release): 90 mg Oral solution: 20 mg/5 ml Tablets: 10 mg, 15 mg, 20 mg Indications and dosages➣ Major depressive disorder (MDD) Adults: 20 mg/day P.O. in morning. After several weeks, may increase by 20 mg/day at weekly intervals. Give dosages above 20 mg/day in two divided doses (morning and noon); don't exceed 80 mg/day. Patients stabilized on 20 mg/day may be switched to 90-mg/week delayed-release capsules (Prozac Weekly) 7 days after last 20-mg dose. Children ages 8 to 18: Initially, 10 to 20 mg/day P.O. After 1 week at 10 mg daily, dosage should be increased to 20 mg/day. However, because of higher plasma levels in lower-weight children, starting and target dose in this group may be 10 mg/day. Dosage increase to 20 mg/day may be considered after several weeks if insufficient clinical improvement occurs. ➣ Obsessive-compulsive disorder (OCD) Adults: Initially, 20 mg/day P.O. in morning. After several weeks, may increase dosage. Give doses above 20 mg/day once daily (morning) or in two divided doses b.i.d. (morning and noon). Dosage range of 20 to 60 mg/day is recommended; however, dosages of up to 80 mg/day have been well tolerated. Don't exceed 80 mg/day. Children ages 7 to 17: Initially, 10 mg/day P.O. in morning in adolescents and higher-weight children; after 2 weeks, may increase dosage to 20 mg/day. Additional dosage increases may be considered after several more weeks if insufficient clinical improvement occurs. Dosage range of 20 to 60 mg/day is recommended. Initially, 10 mg/day P.O. in lower-weight children; may increase dosage after several more weeks if insufficient clinical improvement occurs. Dosage range of 20 to 30 mg/day is recommended. Experience with daily doses greater than 20 mg is very minimal; there is no experience with doses greater than 60 mg. ➣ Acute treatment of depressive episodes associated with bipolar I disorder Adults: Initially, 20 mg fluoxetine P.O. with 5 mg olanzapine P.O. daily; dosage range of fluoxetine is 20 to 50 mg; olanzapine, 5 to 12.5 mg. Safety of fluoxetine doses above 75 mg and olanzapine doses above 18 mg haven't been established ➣ Bulimia nervosa Adults: 60 mg/day P.O.; may be titrated upward over several days ➣ Panic disorder Adults: 10 mg/day P.O. for 1 week; then, if needed, increase to 20 mg/day. Dosage increases of up to 60 mg/day may be considered after several weeks if patient doesn't respond to lower dosage. ➣ Premenstrual dysphoric disorder Adults: 20 mg/day (Sarafem) P.O., not to exceed 80 mg/day Dosage adjustment• Hepatic impairment • Concurrent disease or multiple concomitant medications • Pregnant women during third trimester • Elderly patients Off-label uses• Diabetic peripheral neuropathy • Alcoholism • Bipolar II disorder • Borderline personality disorder • Narcolepsy • Posttraumatic stress disorder • Schizophrenia • Social phobia Contraindications• Hypersensitivity to drug • MAO inhibitor use within past 14 days • Concurrent use of thioridazine or within 5 weeks of discontinuing fluoxetine • Concurrent use of pimozide PrecautionsUse cautiously in: • hepatic or renal impairment, diabetes mellitus, cardiovascular disease, concomitant illness, acute narrow-angle glaucoma • history of seizures, serotonin syndrome or neuroleptic malignant syndrome, clinical worsening and suicidal thinking and behavior, activation of mania or hypomania • hyponatremia in association with syndrome of inappropriate antidiuretic hormone secretion • concurrent use of NSAIDs, aspirin, warfarin, or other drugs that affect coagulation • concurrent use of tryptophan (use not recommended) • pregnant patients (third trimester) • breastfeeding patients (use not recommended) • children younger than age 7 (in OCD use), younger than age 8 (in MDD use), younger than age 18 for all other uses (safety and efficacy not established). AdministrationSee Be aware that drug should be discontinued 5 weeks before MAO inhibitor or thioridazine therapy begins. • Give before 2 P.M. to prevent nighttime insomnia. • Be aware that drug should be gradually reduced rather than abruptly stopped whenever possible.  Adverse reactionsCNS: anxiety, drowsiness, headache, insomnia, abnormal dreams, dizziness, fatigue, nervousness, hypomania, mania, weakness, tremor, seizures, suicidal ideation CV: chest pain, palpitations, prolonged QTc interval EENT: visual disturbances, stuffy nose, sinusitis, pharyngitis GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, dry mouth, anorexia GU: urinary frequency, sexual dysfunction, dysmenorrhea Metabolic: hypouricemia, hypocalcemia, hyponatremia, hyperglycemia, hypoglycemia Musculoskeletal: joint, back, or muscle pain Respiratory: cough, upper respiratory tract infection, dyspnea, respiratory distress Skin: diaphoresis, pruritus, erythema nodosum, flushing, rash Other: abnormal taste, weight loss, fever, flulike symptoms, hot flashes, serotonin syndrome, neuroleptic malignant syndrome (NMS), allergic reactions, hypersensitivity reactions InteractionsDrug-drug. Adrenergics: increased sensitivity to adrenergics, increased risk of serotonin syndrome Alprazolam: decreased metabolism and increased effects of alprazolam Antihistamines, opioids, other antidepressants, sedative-hypnotics: additive CNS depression Aspirin, NSAIDs, warfarin, other drugs that affect coagulation: increased risk of GI or other bleeding Buspirone: potentiation of fluoxetine effects, increased risk of seizures Carbamazepine, clozapine, digoxin, haloperidol, lithium, phenytoin, warfarin: increased blood levels of these drugs, greater risk of adverse reactions CYP450-2D6 inducers: increased effects of these drugs Cyproheptadine: decrease in or reversal of fluoxetine effects Digoxin, warfarin, other highly protein-bound drugs: increased risk of adverse reactions to either drug Efavirenz, ritonavir, saquinavir, other CYP450 inhibitors: serotonergics, triptans: increased risk of serotonin syndrome MAO inhibitors: confusion, agitation, seizures, hypertension, and hyperpyrexia (serotonin syndrome) Pimozide: increased risk of drug interaction or QTc-interval prolongation Thioridazine: increased risk of QTc-interval prolongation or potential for elevated thioridazine plasma level Other antidepressants, phenothiazines, risperidone, tryptophan: increased risk of adverse reactions Ritonavir: increased ritonavir blood level Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, blood urea nitrogen, creatine kinase, electrolytes, glucose: increased levels Sodium: decreased level Drug-herbs. St. John's wort: increased risk of serotonin syndrome Drug-behaviors. Alcohol use: additive CNS depression Patient monitoringSee Monitor patient for signs and symptoms of depression. Assess for suicidal ideation. See Evaluate neurologic status, watching especially for seizures. See Monitor cardiovascular status, particularly for prolonged QTc interval. • Assess weight regularly. Watch for signs of eating disorders. See Monitor patient for signs and symptoms of allergic reactions, serotonin syndrome, or NMS-like reactions. Discontinue drug immediately and initiate supportive treatment if these reactions occur. Patient teaching• Encourage patient to establish effective bedtime routine to minimize sleep disorders. • Tell patient drug may take 4 weeks or longer to be fully effective. See Instruct patient to contact prescriber if he develops worsening depression or has suicidal thoughts. See Instruct patient to immediately stop drug and report signs and symptoms of allergic reactions (rash), serotonin syndrome, or neuroleptic malignant syndrome-like reactions. • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness. • Tell female patient to inform prescriber if she is pregnant or breastfeeding. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above. Prozac(prō′zăk′)Prozac®Fluoxetine Neuropharmacology An oral selective serotonin reuptake inhibitor–SSRI used for depression, obsessive-compulsive disorder, bulimia nervosa Adverse effects 10-15% of Pts experience anxiety, nervousness, insomnia, weight loss, overstimulation, upset stomach, headache Contraindications MAOI therapy. See SSRI–serotonin-selective reuptake inhibitor.ProzacA brand name for FLUOXETINE. This widely used mood-controlling drug can interact dangerously with drugs of the MAO inhibitor group and some other antidepressants.Prozac
Synonyms for Prozac
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Prozac - a selective-serotonin reuptake inhibitor commonly prescribed as an antidepressant (trade names Prozac or Sarafem); it is thought to work by increasing the activity of serotonin in the brain