SAMe

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SAMe

(sam-ee) ,

Ademetionine

(trade name),

S-adenosylmethionine

(trade name), (trade name)

Classification

Therapeutic: antidepressants
Pregnancy Category: UK
Treatment of depressionHas also been used to manage:
  • osteoarthritis
  • fibromyalgia
  • liver disease
  • migraine headaches

Action

May aid in the production, activation, and metabolism of various amines, phospholipids, hormones, and neurotransmitters. May stimulate articular cartilage growth and repair.

Therapeutic effects

Decreased depression.
Anti-inflammatory and analgesic effects improve symptoms of osteoarthritis.

Pharmacokinetics

Absorption: Rapidly and extensively metabolized following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Actively metabolized by the liver.
Half-life: 100 min.

Time/action profile (antidepressant action)

ROUTEONSETPEAKDURATION
PO (depression)1–2 wkunknownunknown
PO (osteoarthritis)30 daysunknownunknown

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Bipolar disorder.
Use Cautiously in: Pregnancy, lactation, or children (safety not established); Bipolar disorder (can induce mania); Parkinson's disease (may worsen symptoms); Surgery (discontinue 2 weeks prior to elective procedures).

Adverse Reactions/Side Effects

Central nervous system

  • agitation
  • dizziness
  • mild insomnia
  • manic reactions (in patients with bipolar disorder)

Gastrointestinal

  • vomiting
  • diarrhea
  • flatulence

Interactions

Avoid use with antidepressants, meperidine, pentazocine, tramadol, and dextromethorphan (additive serotinergic effects may occur).May ↓ effectiveness of levodopa and worsen Parkinsonian symptoms.Should not be used concurrently with MAO inhibitors. Avoid use of SAMe within 2 wk of using a MAO inhibitor.Avoid use with natural products that increase serotonin levels such as l-tryptophan and St. John's wort.
Oral (Adults) Depression—200 mg once or twice daily, adjusted upward over 2 wk (range 400–1600 mg/day); Liver disorders—1200–1600 mg/day; Osteoarthritis—200 mg tid; Fibromyalgia—800 mg/day.

Availability

Tablets: 100 mg, 200 mg, 400 mgOTC

Nursing implications

Nursing assessment

  • Assess mental status for symptoms of depression prior to and periodically during therapy; advise patients with depression to be evaluated by a health care professional.
  • Assess symptoms of pain and fatigue prior to and periodically during therapy.

Potential Nursing Diagnoses

Ineffective coping (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Oral: Administer on an empty stomach. Initial dose should be 200 mg once or twice daily to minimize GI disturbances. Dose may be adjusted upward over 1–2 wks depending on response and tolerance.

Patient/Family Teaching

  • Instruct patient to take SAMe as directed.
  • Advise patients to discontinue 2 weeks prior to elective surgical procedures.
  • Advise women to consult health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

  • Decrease in symptoms of depression.
  • Improvement in osteoarthritis symptoms.
References in periodicals archive ?
Accordingly, it is sameness not likeness that needs to do all the work in the argument that is supposed to lead to the postulation of separate forms.
Is it that the training itself has developed to produce a more technical dancer highly capable of sameness at the expense of individual expression?
This isn't the first time that sameness in modern life has come within my radar.
The slow evolution of Don Quixote's and Sanchos mindsets reveals, on the one hand, Don Quixote's ultimate rejection of the feudal order (that he had so obsessively romanticized in a great part of his journey), and on the other, ascribes Sanchos success as a governor to his "unconcern for social difference and embrace of sameness" (88), which leads him to show a complete indifference for the wealth and distinction associated with the position.
'There's a narcissistic mirror in the other; there's that biological sameness that's going to create similar characteristics.
Reservations manager Djamel Guermit commented: "This is initiative by Sameness Project is really wonderful and amazing, it gives you the opportunity to go out there and get to know these men that works hard to build this city and keeping it beautiful."
"It is not about giving water, this is about giving a break and having a moment of connection to these workers," said Lina Nahhas, 43, founder of the Sameness Project, which has been reaching out to the city's workerssince 2010.
Restart The Art, launched by the (sameness) project in December, partnered workers from Al Futtaim Carillion and Khansaheb with 43 artists and art students to create collaborative art pieces, highlighting each person's dream, pain and joy.
"This is our newest initiative and hands down, biggest yet," said Fiona Hepher of the Sameness Project.
The 2014 film adaptation closely follows the book's portrayal of a seemingly utopian society that has been structured to generate "sameness" to avoid all things bad, such as war, starvation, and violence.
According to the company, the CP provides new scientific data on gene expression and evidence to support arguments regarding active ingredient sameness, immunogenicity and bioequivalence testing with regard to its relapsing-remitting multiple sclerosis medicine, COPAXONE.
The sameness of the documents that are being distributed to us stems from the fact that eight years of rule of this coalition has no difference in determining the strategic goals and priorities.