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pharm exam #2

antidepressants

QuestionAnswer
Antimanics are used in the treatment of mood disorders
Lithium is the most commonly used drug for the treatment of mania
Lithium is an element that is similar in chemical properties to sodium
Sodium is required for conduction of nerve impulses, but lithium interferes with nerve conduction.
Sodium range: 135-145
lithium works to ____ the reuptake of NE and Dop. increase
Lithium takes how many weeks to fully work? 1-2 wks
Adequate sodium intake is necessary for proper... urinary excretion of lith.
therapeutic blood levels range 0.5 to 1.5 mEq/L
lithium maintenance dose: 900-1200mg/day
lithium drug interactions: haldol, diuretics
MOOD STABILIZERS:second best choice in the treatment of mania are anticonvulsants
examples of anticonvulsants: Depakote, GABApentin, Carbamazepine
3rd best choice: Propranolol
Propranolol nursing considerations do not give if pulse is below 60
exogenous reactive depression-caused by external factors death or unemployment, loss
endogenous caused by internal factors. Nobody ever has. Hard to diagnose. Chemical imbalance neurotransmitters. Can last for a long time. Postpartum. Get under control.
What is the role of serotonin? moods, arousal levels, appetite, sleep disturbances (endogenous depression) main one have to restore
role of NE? NE- cardiovascular system, fight or flight, moods
Drugs that can increase the level of norepinephrine or serotonin in the brain are useful in the treatment OF DEPRESSION
antidepressants take about 2 to 4 weeks to work fully in the body.
Monoamine Oxidase Inhibitors (MAOIs) an enzyme found in most body cells.break down norepinephrine and serotonin
Why is this bad in relation to depression? We need Serotonin and NE to increase
Tyramine can produce a massive release of NE, which can result in hypertensive crisis or cerebral stroke.
Which foods must one avoid? Ginseng, chocolate, beer, cheese, pickles, olives, wine and avocado
Side effects and adverse effects of MAOI: dry mouth, urinary ret, constipation, blurred vision, hypotension, weight gain, and sex dysfunction. can produce liver damage.
Phenylzine (Nardil) MAOI
Tricyclic Antidepressants or (TCAs) block the reuptake of norepinephrine and serotonin.
anticholinergic sx: dry mouth, constipation, urinary ret, tachycardia, and hypertension.
TCAs: Nortriptyline (Aventyl) Amitriptyline (Elavil) Doxepin (Sinequan) Imipramine (Tofranil)
Selective Serotonin Reuptake Inhibitors (SSRIs) block the reuptake and inactivation of serotonin in the brain.
Sertraline (Zoloft) dosage: 50-200mgPO
Fluoxetine (Prozac) dosage: 20-40mgPO
Prozac does not mix well anticoagulants and benzodiazepines (Xanax).
Prozac is also effective in the treatment OCD
Side and Adverse effects of (SSRIs): nausea, diarrhea, dry mouth, anorexia, and GI disturbances.
Adverse effects OF SSRIs 1) Weight loss 2) Insomnia 3) Tremors 4) Nervousness
Second group of SSRIs are the atypicals. Bupropion (Wellbutrin) & Venlafaxine (Effexor)
atypical SSRI Duloxetine (Cymbalata) If you have depression, diabetic neuropathy pain, fibromyalgia, generalized anxiety disorder, or chronic pain, a healthcare provider may prescribe:
TCAs may also produce effects in heart and liver
TCAs are safer comapred to... MAOIs
Created by: Brittneegarza