![]() ![]() The psychiatrist can also monitor the patient clinically for improvement, or if needed, make changes in the medication. This interprofessional paradigm can improve patient outcomes through enhanced treatment strategies and information sharing. Nursing should be alert to signs of adverse drug events, improvement in status, or the need for further evaluation and report such to the clinician. This approach allows the patient to have a correct dosage based on their co-morbid conditions. Each patient is unique some may require a different dosage because of renal or hepatic dysfunction. The pharmacist can provide the dosing for the patient and monitor toxicity levels and consult with the prescriber for changes. Each department acknowledges what the patients' needs and implement the plan. This team starts with the prescribing clinicians (MD, DO, PA, NP), who will make the initial determination for using paroxetine. Open communication between various disciplines, such as pharmacy and psychiatry, can benefit the patient. However, im experiencing the same problem as I did with paxil. Anyway, I switched to effexor because of the lower incidence of sexual sides. ![]() Interprofessional teamwork can impact a patient's outcome positively. Shit, I got off paxil because it inhibited my ability to have an orgasm (well, at least for a few hours). Based on epidemiological studies, infants exposed to paroxetine during the first trimester had an increased risk for cardiovascular malformations. Paroxetine is not recommended for use during pregnancy or if breastfeeding. Tamoxifen is active once metabolized by CYP4502D6 thus, paroxetine essentially inactivates tamoxifen. Precautions that should be acknowledged when prescribing paroxetine include concurrent tricyclic antidepressant (TCA) use, concomitant tamoxifen use, and drugs affecting hepatic metabolism. Paroxetine inhibits TCA metabolism, leading to possible TCA toxicity. Concurrent use of thioridazine and paroxetine can induce cardiac arrhythmias similar effects can occur with pimozide and paroxetine. Concomitant use of MAOIs and paroxetine can precipitate serotonin syndrome. ![]() Absolute contraindications include concurrent use of monoamine oxidase inhibitors (MAOIs), thioridazine, and pimozide. There are only a few absolute contraindications for the use of paroxetine. ![]()
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