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Drug Tx for Depression- Mental Health

Tricyclic Side Effects Anticholinergic (dry mouth, blurred vision, constipation, urinary retention), orthostatic hypotension, tachycardia, drowsiness.
Tricyclic pt. teaching and interventions Given at bedtime (drowsiness). Take 1-4 wks to work. Lethal in OD (cardio toxic, usually not prescribed to cardia pt). Not ideal for gerian (anticholinergic s/e). Often used to treat nerve pain (diabetic neuropathy)
Elavil Tricyclic
Ascendin Tricyclic
Norpramin Tricyclic
Sinequan Tricyclic
Anafranil Tricyclic
SSRI and SNRI Side Effects Minimal anticholinergic effects. Anxiety. Nervous energy. Insomnia. Sexual dysfunction. Long term wt. gain.
SSRI and SNRI pt. teaching and interventions Good for elderly (reduced anticholinergic effects). Considered first choice drugs to treat depression. Taken in AM (if drowsy, switch to PM). Take 1-4 wks to work. Not to be taken in pregnant (fetal heart defects).
Prozac SSRI- strongest "chief" SSRI. Wt. loss initially.
Paxil SSRI
Zoloft SSRI- can cause wt. loss
Celexa SSRI
Lexapro SSRI
Cymbalta SNRI
Effexor/Pristique SNRI
Remeron SNRI- causes wt. gain
Vestra SNRI
Wellbutrin Misc.- Good to stop smoking w/
Desryel Misc.- Tricyclic of choice, but is actually a bicyclic. Help sleep. Fewest anticholinergic effects.
MAOI Side Effects Hypertensive Crisis...Headache, flushing, chest pain, epistaxis (nose bleed), dizziness, neck pain.
MOAI pt. teaching and interventions Last choice drugs for depression. Must avoid Tyramine, Tryptophan, & Epinephrine- put instructions in writing. Any symptoms, go to ER! Every OTC cold product has epinephrine. Need 2 wk gap between any other psych drug & MAOI (serotonin syndrome)
Foods you can not eat while taking MAOI's Avacodos, figs, brown/ripe bananas, processed meats, wine, beer, real cheese, bakery breads, chocolate, liver, salmon. No soy, no caffeine.
Nardil MAOI
Parnate MAOI
Lithium Carbonate Anti-manic drug prescribed for bipolar disorder.
How long does Lithium take to be effective? 10-21 days
Usual dosage of Lithium 300-600 mg, usually given BID or TID
Range of Lithium 0.5-1.5 mEq
Ideal/therapeutic Lithium level 0.8-1.2 mEq
Lithium toxicity Blood levels greater than 1.5 mEq
Lithium Side Effects Nausea, fine tremors, headache, polydipsia, polyuria, muscle weakness, wt. gain.
Early Lithium toxicity N&V, abdominal pain, diarrhea.
Advanced Lithium toxicity Tremors, slurred speech, ataxia, seizures.
Pt. teaching for Lithium 2000-3000 mL fluid/day. Maintain normal salt intake, eat balanced diet. Do not take Ibprofen/NSAID's (Lithium toxicity). Low potassium=Lithium toxicity.
Created by: fulk_90