Assessment

• Obtain weight and BMI initially and periodically throughout treatment

• Assess fasting glucose and cholesterol levels in overweight/obese individuals

• Monitor blood pressure and pulse before and during initial therapy. Notify physician or other health care professional of decreases in blood pressure (10–20 mmHg) or sudden increase in pulse rate. Patients taking high doses or with a history of cardiovascular disease should have ECG monitored before and periodically during therapy

• Monitor mental status (orientation, mood behavior) frequently. Assess for suicidal tendencies, especially during early therapy. Restrict amount of drug available to patient

• Assess intensity, quality, and location of pain periodically during therapy. May require several weeks for effects to be seen. Use pain scale to monitor effectiveness of medication. Assess for sexual dysfunction (decreased libido; erectile dysfunction). Geri: Geriatric patients started on amitriptyline may be at an increased risk for falls; start with low dose and monitor closely. Assess for anticholinergic effects (weakness and sedation).

• Assess leukocyte and differential blood counts, liver function, and serum glucose before and periodically during therapy. May cause an serum bilirubin and alkaline phosphatase. May cause bone marrow depression. Serum glucose may be or

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