Citalopram - Revision history

Zeki at 05:57, 1 August 2024

2024-08-01T05:57:30Z

← Older revision		Revision as of 01:57, 1 August 2024
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	***Monitor for persistent QTc measurements greater than 500 ms and discontinue citalopram if necessary		***Monitor for persistent QTc measurements greater than 500 ms and discontinue citalopram if necessary
	**Monitor for abnormal bleeding		**Monitor for abnormal bleeding

			'''Drug Interactions

			Major Drug interactions
			*Serotonergic Drugs
			**Drugs: Other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, St. John's Wort
			**Risk: Increased risk of serotonin syndrome
			**Management:
			***Monitor for signs and symptoms of serotonin syndrome, especially during initiation or dose changes

			*QT-Prolonging Medications
			**Risk: Increased risk of QT prolongation and life-threatening arrhythmias
			**Management:
			***Perform ECG before starting treatment, especially in high-risk patients
			***Avoid combination if possible, or use with caution and close monitoring
			***Monitor electrolytes, particularly potassium and magnesium

			Anticoagulants and Antiplatelet Agents*
			**Risk: Increased risk of bleeding
			**Management:
			***Inform patients of increased bleeding risk
			***Monitor closely, especially INR for patients on warfarin

			*Other Significant Interactions
			**NSAIDs: May increase bleeding risk; use with caution
			**CYP2C19 inhibitors: May increase citalopram levels; dose adjustment may be necessary

			==FAQ==
			'''How Should I Take the Tablet?

			Take once daily, with or without food.

			'''What Should I Avoid While Taking?

			Avoid alcohol and activities requiring mental alertness until you know how trifluoperazine affects you.

			'''What Happens if I Miss a Dose?

			Take the missed dose as soon as you remember unless it is almost time for your next dose. Do not double doses.

Zeki at 05:50, 1 August 2024

2024-08-01T05:50:26Z

← Older revision		Revision as of 01:50, 1 August 2024
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	\| Seizures		\| Seizures
	\|}		\|}

			==Pharmacokinetics==
			*Peak plasma level is approximately 4 hours after oral dosing
			*Metabolism: Citalopram is primarily metabolized in the liver by CYP3A4 and CYP2C19.
			*Elimination: Half-life is about 35 hours. Approximately 12-23% of an oral dose is excreted unchanged in urine and about 10% is excreted in feces.
			These pharmacokinetic properties contribute to citalopram's once-daily dosing regimen.

			Onset Time and Duration of drug action
			*Onset: Therapeutic effects typically observed within 1-4 weeks.
			*Duration: Steady-state achieved within 1 week.

			==Drug Precautions==
			'''Pregnancy

			May cause complications such as persistent pulmonary hypertension of the newborn (PPHN) and poor neonatal adaptation if used in the third trimester.

			'''Breastfeeding

			Use with caution; citalopram is excreted in human milk.

			'''Children and Elderly
			*Children: Safety and effectiveness not established in pediatric patients
			*Elderly: Recommended dose is 20 mg/day due to increased sensitivity

			'''Renal Impairment

			No dosage adjustment necessary for mild-to-moderate impairment; use with caution in severe impairment

			'''Monitoring Requirements

			Citalopram, a selective serotonin reuptake inhibitor (SSRI), requires careful monitoring and management to ensure patient safety and therapeutic efficacy. Here are the key aspects of moritoring and management:

			Before Treatment
			*Electrolytes:
			**Monitor and evaluate baseline levels of potassium and sodium
			**Correct any hypokalemia or hypomagnesemia before starting treatment
			**Periodically re-evaluate electrolytes, especially in patients at riks for electrolyte disturbances
			*ECG Monitoring:
			**Perform an ECG to check for QT prolongation in patients with congenital long QT syndrome, bradycardia, hypokalemia, hypomagnesemia, recent acute myocardial infarction, or uncompensated heart failure.
			**Avoid citalopram or use with caution in patients taking other QT-prolonging drugs

			Drug Treatment
			*Mental Health Monitoring:
			**Assess and monitor for worsening depression, suicidality, or unusual changes in behavior, particularly during the initial few months of therapy or when adjusting doses
			**Weekly face-to-face contact is recommended during the first month, followed by bi-weekly visits for the next month, and then at 3-month intervals
			*Weight and Growth:
			**Regularly monitor weight and growth in children and adolescents undergoing treatment
			*Psychiatric Assessment:
			**Use standardized scales to screen for anxiety and depression and to monitor response to therapy, such as:
			**Patient Health Questionnaire (PHQ-9)
			**Generalized Anxiety Disorder 7 score (GAD-7)
			**Hamilton Anxiety Scale (HAM-A)
			*Toxicity and Overdose Management
			**Serotonin Syndrome
			***Be vigilant for signs of serotonin syndrome, especially if the patient is on other serotonergic medications.
			***Symptoms include agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea
			**Patient Education
			***Educate patients about the risks of combining citalopram with alcohol, sedatives, and other antidepressants
			*Special Considerations:
			**Elderly Patients:
			***The maximum recommended dose for patients older than 60 years is 20 mg per day due to increased risk of QT prolongation
			***Monitor for persistent QTc measurements greater than 500 ms and discontinue citalopram if necessary
			**Monitor for abnormal bleeding

Zeki: /* Side Effects */

2024-08-01T05:20:02Z

Side Effects

← Older revision		Revision as of 01:20, 1 August 2024
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	!Adverse reactions		!Adverse reactions
	\|-		\|-
			\| rowspan="12" \| '''Common
	\| Nausea		\| Nausea
	\|-		\|-

Zeki at 05:19, 1 August 2024

2024-08-01T05:19:32Z

← Older revision		Revision as of 01:19, 1 August 2024
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	===Citalopram 20mg===		===Citalopram 20mg===
	[[File:Citalopram 20mg.mp3]]		[[File:Citalopram 20mg.mp3]]

			==Common Strengths of Citalopram Tablet==
			Citalopram are available in the following strengths:
			*Tablets: 10 mg, 20 mg, 40 mg
			*Oral solution: 10 mg/5 mL

			==Drug Trade Names of Citalopram Tablet==
			CIPRAM

			==Drug Usage==
			*Major depressive disorder (MDD) in adults
			*Off-label uses: Generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, premenstrual dysphoric disorder (PMDD)

			==Mechanism of Action==
			It works by increasing serotonin levels in the brain by inhibiting its reuptake into presynaptic neurons, thereby enhancing serotonergic activity.

			==Route of Administration==
			Oral (tablets and solution)

			==Dosages==
			*Initial dose: 20 mg once daily
			*Maintenance dose: 20 - 40 mg once daily
			*Maximum dose: 40 mg/day
			*Elderly: Recommended dose is 20 mg/day

			==Side Effects==
			{\| class="wikitable"
			!style="text-align: left"\| Frequency
			!Adverse reactions
			\|-
			\| Nausea
			\|-
			\| Dry mouth
			\|-
			\| Increased sweating
			\|-
			\| Drowsiness
			\|-
			\| Insomnia
			\|-
			\| Dizziness
			\|-
			\| Fatigue
			\|-
			\| Weakness
			\|-
			\| Tremor (shaking)
			\|-
			\| Sexual dysfunction (e.g. decreased libido, difficulty achieving orgasm, erectile dysfunction)
			\|-
			\| Diarrhea or constipation
			\|-
			\| Loss of appetite
			\|-
			\| rowspan="9" \| '''Serious
			\| Allergic reactions: Symptoms such as hives, difficulty breathing, and swelling of the face, lips, tongue, or throat
			\|-
			\| Serotonin syndrome: Symptoms include agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea
			\|-
			\| QT prolongation: A dangerous heart rhythm condition that can lead to torsades de pointes. Symptoms may include fainting, dizziness, or irregular heartbeat
			\|-
			\| Suicidal thoughts or behaviors: Particularly in young adults, teenagers, and children, especially when starting the medication or adjusting the dose
			\|-
			\| Manic episodes: Symptoms include racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, and being unusually talkative or agitated
			\|-
			\| Severe nervous system reactions: Symptoms include very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, and tremors
			\|-
			\| Unusual bleeding: Including nosebleeds, bleeding gums, abnormal vaginal bleeding, or any bleeding that does not stop
			\|-
			\| Low blood sodium (hyponatremia): Symptoms include headache, confusion, problems with thinking or memory, weakness, and feeling unsteady
			\|-
			\| Seizures
			\|}

Zeki at 05:04, 1 August 2024

2024-08-01T05:04:44Z

← Older revision		Revision as of 01:04, 1 August 2024
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	[[Category: Drugs]][[Category: Selective serotonin reuptake inhibitor]]		[[Category: Drugs]][[Category: Selective serotonin reuptake inhibitor]]

			[[:Category: Antidepressant Drug \| '''Antidepressant Drug''']]

			'''Drug class: [[:Category: Selective serotonin reuptake inhibitor \| Selective Serotonin Reuptake Inhibitor]]

			'''Citalopram (CIPRAM)'''（中文：[[西酞普蘭]]）
	==Pronunciation==		==Pronunciation==
	===Citalopram 20mg===		===Citalopram 20mg===
	[[File:Citalopram 20mg.mp3]]		[[File:Citalopram 20mg.mp3]]

Zeki at 07:25, 25 July 2024

2024-07-25T07:25:48Z

← Older revision		Revision as of 03:25, 25 July 2024
Line 1:		Line 1:
	[[Category: Drugs]]		[[Category: Drugs]][[Category: Selective serotonin reuptake inhibitor]]
	==Pronunciation==		==Pronunciation==
	===Citalopram 20mg===		===Citalopram 20mg===
	[[File:Citalopram 20mg.mp3]]		[[File:Citalopram 20mg.mp3]]

Colin Bot: Populate pages with audio

2020-09-08T09:40:09Z

Populate pages with audio

← Older revision		Revision as of 05:40, 8 September 2020
Line 1:		Line 1:
	[[Category: Drugs]]		[[Category: Drugs]]
	==Pronunciation==		==Pronunciation==
	===Citalopram 20mg.===		===Citalopram 20mg===
	[[File:Citalopram 20mg.mp3]]		[[File:Citalopram 20mg.mp3]]

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2020-09-08T09:27:08Z

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[[Category: Drugs]]
==Pronunciation==
===Citalopram 20mg.===
[[File:Citalopram 20mg.mp3]]