Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Anti-depressant Meds
| Question | Answer |
|---|---|
| Tricyclic Anti-depressant (TCAs) | Amitriptyline Imipramine Clomipramine |
| True or false "Tricyclic is a second line drug" ? | True |
| True or false "If patient is depressed or suicidal do NOT give Tricyclic" | True |
| Nursing Implications for Tricyclic | Assess baseline physical & emotional status. Obtain baseline vital signs, including postural BP Monitor for CNS depression, dizziness, confusion Dispense small amounts |
| PRECAUTIONS for Tricyclic | Sedation, anticholinergic effects Use caution in older adults (fall risk) May need to ne weened off or discontinued before surgery to prevent anesthetic interaction. DO NOT COMBINE WITH ALCOHOL or CNS depressants!! |
| Monoamine Oxidase Inhibitors (MAOIs) | Phenelzine Tranylcypromine Isocarboxazid Selegiline |
| Nursing implications for monoamine oxidase inhibitors | Educate patient and family on tyramine-containing foods to avoid Monitor vital signs (especially BP) Assess for headache, dizziness, palpitations, nausea Encourage wearing medication ID bracelet. |
| Precautions for Monoamine (MAOIs) | Risk of hypertensive crisis with tyramine containing foods or certain drugs Orthostatic hypotension, insomnia, dizziness, headache, nausea Avoid OTC decongestants, sympathomimetics and certain prescription drugs DO NOT combine with SNRIs, or other sero |
| Tyramine-containing foods to AVOID | Aged cheese (cheddar, blue swiss) Aged, smoked meats, fish, poultry Yeast extracts Red wines (Chianti, burgundy, sherry, vermouth) Fava beans |
| Second generation anti-depressants | SSRIs: Prozac, zoloft, paxil, lexapro SNRIs: Venlafaxine (effexor) Duloxetine (cymbalta) NDRI: Bupropion (Wellbutrin, zyban) Others: Trazadone, Mirtazapine |
| True or false "Second generation antidepressants have fewer adverse effects and is FIRST LINE drugs for most patients" | True |
| Nursing implications for second generation antidepressants | Provide simple explanations about meds, effects & time to benefit (4-6 weeks) Advise to take consistently, do NOT stop abruptly Monitor for improvement, suicidal thoughts, or worsening mood Assist with ADLs if drowsy or weak (fall risk) |
| Precautions for second generation antidepressants | Common: headache, nausea, GI upset, insomnia, sexual dysfunction. Report signs of serotonin syndrome Interactions with other serotonergic drugs & St John's wort Mat cause weight gain or weight loss |
| Serotonin syndrome | REPORT IMMEDIATELY!! Symptoms: Delirium, tachycardia, hyperreflexia, shivering, agitation, sweating, muscle spasms, coarse tremors. |
| Severe serotonin symptoms | Hyperthermia, seizures, renal failure, rhabdomyolysis, dysrhythmias, disseminated intravascular coagulation |
| Herbal product | St. John's Wort used for depression, anxiety, sleep disorders, nervousness. |
| Precautions for St. John's Wort | May cause GI upset, fatigue, dizziness, confusion, dry mouth, photosensitivity. Severe interactions with MAOIs, SSRIs, and many other drugs AVOID tyramine- containing foods!! |
| True or false "Ask patient about herbal and OTC use, and educate patient on potential interactions for st. john's wort | True |
| Mood stabilizers | Used to treat mania and prevent mood episodes in bipolar disorder. Help stabilize extreme mood swings |
| Mood stabilizer medications | Lithium carbonate Valproic acid (Depakote) Carbamazepine (Tegretol) Lamotrigine (lamictal) |
| Lithium therapeutic levels | 0.6-1.2 mEq/L |
| Nursing implications for mood stabilizer meds | Assess mood, mental status, and suicide risk Monitor vital signs and weight measure I&O, maintain hydration use lowest effective dose, give as prescribed. |
| Toxic lithium level | 1.5 SERIOUS TOXICITY |
| Mood stabilizer precautions | Valproate (avoid in pregnancy) Carbamazepine (risk for severe rash) many drug interactions Lamotrigine risk for serious rash- titrate slowly Do not stop abruptly avoid alcohol and other CNS depressants |
| Antipsychotics | Used to treat psychosis, schizophrenia, bipolar mania, and severe behavioral disorders. |
| Antipsychotic medications | First generation medications: Haloperidol (Haldol) Chlorpromazine (Thorazine) |
| Antipsychotic medications cont. | Second generation meds: Risperidone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Aripiprazole (Abilify) |
| Antipsychotic precautions | Neuroleptic malignant syndrome (NMS) Extrapyramidal symptoms Tardive Dyskinesis Orthostatic hypotension Metabolic effects Anticholinergic effects |
| Neuroleptic Malignant Syndrome (NMS) | High fever, muscle rigidity, autonomic instability. STOP DRUG AND SEEK EMERGENCY TREATMENT |
| Benztropine (Cogentin) | Given to reverse the extrapyramidal symptoms Dystonia akathisa parkinsonism treat early! |
| Clozapine | Monitor WBC can cause infection if wbc count gets too low. Lower neutrafill counts (WBC) |
Created by:
Sarabowden1