Atomoxetine

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.

Atomoxetine (brand name Strattera) — ADHD agent (nonstimulant); Selective norepinephrine reuptake inhibitor.

Identification

• Therapeutic class: ADHD agent (nonstimulant).
• Pharmacologic class: Selective norepinephrine reuptake inhibitor.

Pharmacology

• Mechanism of action: Increases norepinephrine; nonstimulant and noncontrolled.
• Onset / peak / duration: Effect builds over 2 to 4 weeks.
• Half-life / therapeutic level: Half-life about 5 hours (longer in poor metabolizers); level not routine.

Clinical use

• Indications: ADHD.
• Usual dose, route, frequency: PO once or twice daily.
• Maximum dose / adjustments: Reduce in hepatic impairment and with CYP2D6 inhibitors.

Safety

• Contraindications: MAO inhibitor use, narrow-angle glaucoma, serious cardiac disease, pheochromocytoma.
• Black box warning: Increased risk of suicidal ideation in children and adolescents.
• Interactions: MAO inhibitors, CYP2D6 inhibitors (paroxetine, fluoxetine), pressor agents.
• Pregnancy / lactation: Use only if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Decreased appetite, nausea, fatigue, increased heart rate and blood pressure.
• Serious effects to report: Suicidal thoughts, hepatotoxicity, cardiac events.
• Antidote / reversal: Supportive care.

Nursing process

• Assessment before administration: Mood and suicide risk, cardiac history, blood pressure.
• Interventions during therapy: Monitor mood, especially early; check cardiovascular signs.
• Monitor: Mood, blood pressure, heart rate, LFTs if symptomatic.
• Evaluation / expected outcome: Improved attention without stimulant misuse risk.

Patient teaching

• Patient teaching: Takes weeks to work; report mood changes; not a controlled substance.
• Notify provider if: Suicidal thoughts, yellowing of skin, chest pain.
• Administration tips: With or without food; consistent timing.