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Amitriptyline and nortriptyline - Revision history
2026-06-17T18:49:56Z
Revision history for this page on the wiki
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Docmoates: Add medication infobox (Drugbox) to monographs
2026-06-17T16:09:13Z
<p>Add medication infobox (Drugbox) to monographs</p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 16:09, 17 June 2026</td>
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<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| name = Amitriptyline and nortriptyline</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| brand = Elavil, Pamelor</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| therapeutic = Antidepressant, neuropathic analgesic</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| pharmacologic = Tricyclic antidepressants (TCAs)</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| onset = Mood effect over 2 to 4 weeks; analgesia sooner.</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| halflife = Long; nortriptyline has a therapeutic window often monitored.</ins></div></td></tr>
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<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| highalert = No</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| blackbox = <span style="color:#b00020;">'''Yes'''</span> (see Safety)</ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">| antidote = Sodium bicarbonate for cardiotoxic overdose; supportive care.</ins></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;"></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;"></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''</div></td></tr>
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Docmoates: NCLEX nursing pharmacology monographs — batch import
2026-06-17T14:05:05Z
<p>NCLEX nursing pharmacology monographs — batch import</p>
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''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''<br />
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'''Amitriptyline and nortriptyline''' (brand names Elavil, Pamelor) &mdash; Antidepressant, neuropathic analgesic; Tricyclic antidepressants (TCAs).<br />
<br />
== Identification ==<br />
* '''Therapeutic class:''' Antidepressant, neuropathic analgesic.<br />
* '''Pharmacologic class:''' Tricyclic antidepressants (TCAs).<br />
<br />
== Pharmacology ==<br />
* '''Mechanism of action:''' Block reuptake of norepinephrine and serotonin; strong anticholinergic effects.<br />
* '''Onset / peak / duration:''' Mood effect over 2 to 4 weeks; analgesia sooner.<br />
* '''Half-life / therapeutic level:''' Long; nortriptyline has a therapeutic window often monitored.<br />
<br />
== Clinical use ==<br />
* '''Indications:''' Depression, neuropathic pain, migraine prophylaxis, insomnia (low dose).<br />
* '''Usual dose, route, frequency:''' PO at bedtime, titrated.<br />
* '''Maximum dose / adjustments:''' Caution and lower doses in elderly; cardiotoxic in overdose.<br />
<br />
== Safety ==<br />
* '''Contraindications:''' Recent MI, MAO inhibitor use, narrow-angle glaucoma, arrhythmias.<br />
* '''Black box warning:''' Suicidality in those under 25.<br />
* '''Interactions:''' MAO inhibitors and serotonergic drugs, anticholinergics, QT-prolonging drugs, alcohol.<br />
* '''Pregnancy / lactation:''' Use only if clearly needed.<br />
* '''High-alert:''' No.<br />
<br />
== Adverse effects ==<br />
* '''Common side effects:''' Dry mouth, constipation, blurred vision, sedation, weight gain, orthostatic hypotension.<br />
* '''Serious effects to report:''' Cardiac arrhythmia, suicidal thoughts, severe anticholinergic toxicity, overdose (high lethality).<br />
* '''Antidote / reversal:''' Sodium bicarbonate for cardiotoxic overdose; supportive care.<br />
<br />
== Nursing process ==<br />
* '''Assessment before administration:''' Cardiac history, ECG in older adults, mood and suicide risk.<br />
* '''Interventions during therapy:''' Limit quantity dispensed given overdose risk; rise slowly.<br />
* '''Monitor:''' Mood, ECG, anticholinergic effects.<br />
* '''Evaluation / expected outcome:''' Improved mood or reduced neuropathic pain.<br />
<br />
== Patient teaching ==<br />
* '''Patient teaching:''' Effect takes weeks; rise slowly; dangerous in overdose, keep secured.<br />
* '''Notify provider if:''' Palpitations, fainting, suicidal thoughts, confusion.<br />
* '''Administration tips:''' Bedtime dosing; with food.<br />
<br />
[[Category:Antidepressants]]</div>
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