Clinical Pharma replies

POST # 1 KAREN

Serotonin Reuptake Inhibitors are a class of drugs used most commonly to treat depression and anxiety (Woo & Robinson, 2020) as well as other conditions such as obsessive-compulsive disorder (Ivarsson et al., 2015). The medication acts by inhibiting serotonin from returning to the presynaptic cell (Woo & Robertson, 2020). They are protein bound and metabolized by the CYP450 system and excreted primarily by the kidneys (Woo & Robertson, 2020). The liver is highly involved in their metabolism; therefore, caution should be used in prescribing to patient’s with decreased liver function (Billioti de Gage et al., 2018).

Fluoroquinolones are a class of broad-spectrum antibiotics that function by interfering with enzymes necessary for the synthesis and repair of bacterial DNA (Woo & Robertson, 2020). This class of drugs is widely distributed throughout most body tissues and elimination depends on the specific drug (Woo & Robertson, 2020). Factors that should be considered when prescribing this class of medication include renal function, cardiac status, age, and polypharmacy as these medications are known to cause QT prolongation, especially in the elderly and those taking other QT prolonging medications, and risk of toxicity increases as renal function decreases (Blaszczyk et al., 2020). 

Billioti de Gage, S., Collin, C., Le-Tri, T., Pariente, A., Bégaud, B., Verdoux, H., Dray-Spira, R.,  & Zureik, M. (2018). Antidepressants and Hepatotoxicity: A Cohort Study among 5  Million Individuals Registered in the French National Health Insurance Database. CNS  drugs, 32(7), 673–684.  https://doi.org/10.1007/s40263-018-0537-1 Blaszczyk, A.T., Anderson, S.S. and Hall, R.G. (2020), Appropriateness of Fluoroquinolone  Prescribing in the Long‐Term Care Setting. J Am Geriatr Soc, 68: 661-663.  doi:10.1111/jgs.16324 Ivarsson, T., Skarphedinsson, G., Kornør, H., Axelsdottir, B., Biedilæ, S., Heyman, I., Asbahr,  F., Thomsen, P. H., Fineberg, N., March, J., & Accreditation Task Force of The Canadian  Institute for Obsessive Compulsive Disorders (2015). The place of and evidence for  serotonin reuptake inhibitors (SRIs) for obsessive compulsive disorder (OCD) in children  and adolescents: Views based on a systematic review and meta-analysis. Psychiatry  research, 227(1), 93–103.  https://doi.org/10.1016/j.psychres.2015.01.015 Woo, T.M., & Robinson, M.V. (2015). Pharmacotherapeutics for advanced practice nurse  prescribers. F. A. Davis.