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Stack #39498/Antidep

Antidepressants/mood stabilizers

How is depression characterized by according to Lehne? By depressed mood & loss of pleasure or interest in all or nearly all of one's usual activities
What are the 4 types of antidepressants? Selective Serotonin Re-uptake Inhibitors (SSRI), Tricyclic Antidepressants (TCA), atypical antidepressants, Monoamine Oxidase Inhibitors (MAOI)
What is the function of serotonin? Induces sleep, regulates Temp, controls moods
Why do most people quit taking SSRIs? What are the other AE? Decreased libido & weight gain; nausea, headache, nervousness, insomnia, anxiety.
What are the S&S of serotonergic Syndrome? When can it happen?What is the tx? agitation, confusion, anxiety, hallucinations, poor concentration, profuse diaphoresis, tremor, fever; 2-72 hrs after tx; discontinue drug
How long does it take SSRIs to take effect?Why? 1 month; long half life of 7 dys
What other drugs may increase CNS depression when taking SSRIs? alcohol, antidepressants, sedatives, and opioids
What is the best course of tx when pt is taking an MAOI and is prescribed an SSRI? the MOAI must be withdrawn 14 days before SSRI is taken?
How do TCAs work? block reuptake of norepinephrine and serotonin
What are the AE of TCAs? What are the most common (* answer)? Orthostatic hypotension*, sedation*, anticholinergic effects*, cardiac toxicity, increase seizures, photosensitivity
What can occur in a patient who is treated with a MAOI is and a TCA? Severe hypertension
What other drugs should be avoided when taking a TCA? Anticholinergics/antihistamines, CNS depressants
Name the protype for TCA Amitriptyline
Name the protype for SSRIs prozac
Name an atypical antidepressant? Bupropion
What are atypical antidepressants used for? Depression & smoking cessation
What are AE for atypical antidepressants? agitation, headache, dry mouth, constipation, weight loss, gi upset, blurred vision.
What is the most serious AE for Bupropion? seizures
What may be considered a benefit AE for Bupropion? increased sexual desire
How do MAOIs work? Normally MAO converts NE, dopamine & serotonin into inactive products; if this is inhibited the amount of NE & serotonin increases
What are MAOIs used to tx? atypical depression-- is usually 2nd/3rd choice; OCD, bulimia
What is the most severe AE that can occur w/ MAOI? Hypertensive crisis
What must patients on MAOIs avoid in their diet? Foods containing tyramine--avocados, bananas, chocolate, cheese etc..
What drugs must be avoided when taking MAOI? What might the interactions cause? Cough/cold drugs, asthma drugs, TCAs, ephedrine--cause HTN crisis; Antihypertensives-hypotension; SSRIs-serotonergic syndrome; Meperdine-hyperpyrexia
True/ False: MAOIs are beneficial for suicidal patients? F
What education should be taught to patients in regard to taking their antidepressant? Don't stop taking, they may not work right away, follow up with your doctor, take them as prescribed
What disorder is Lithium used to tx? manic phase of bipolar
What are AEs that occur at therapeutic levels w/ Lithium? Nausea, vomiting, diarrhea, slurred speech, muscle weakness, thirst, polyuria
What are toxic AE of lithium? Seizures, hypotension, stupor, death
Why must lithium levels be monitored? narrow therapeutic index
What other drugs must be used in caution with Lithium? Why? Diuretics because they promote sodium excretion; Lithium excretion is reduced when Na+ levels are too low. Therefore Lithium can accumulate to toxic levels.
What must be monitored when patients are taking Lithium? Na+ levels, I& O, renal function, and lithium plasma levels.
What must be taught to patients who take lithium in regards to their diet? Have constant diet of Na+ intake .
Created by: jrmcdermott