Antidepressants/mood stabilizers
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| 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
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| What are the 4 types of antidepressants? | Selective Serotonin Re-uptake Inhibitors (SSRI), Tricyclic Antidepressants (TCA), atypical antidepressants, Monoamine Oxidase Inhibitors (MAOI)
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| What is the function of serotonin? | Induces sleep, regulates Temp, controls moods
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| Why do most people quit taking SSRIs? What are the other AE? | Decreased libido & weight gain; nausea, headache, nervousness, insomnia, anxiety.
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| 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
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| How long does it take SSRIs to take effect?Why? | 1 month; long half life of 7 dys
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| What other drugs may increase CNS depression when taking SSRIs? | alcohol, antidepressants, sedatives, and opioids
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| 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 | the MOAI must be withdrawn 14 days before SSRI is taken?
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| How do TCAs work? | block reuptake of norepinephrine and serotonin
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| What are the AE of TCAs? What are the most common (* answer)? | Orthostatic hypotension*, sedation*, anticholinergic effects*, cardiac toxicity, increase seizures, photosensitivity
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| What can occur in a patient who is treated with a MAOI is and a TCA? | Severe hypertension
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| What other drugs should be avoided when taking a TCA? | Anticholinergics/antihistamines, CNS depressants
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| Name the protype for TCA | Amitriptyline
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| Name the protype for SSRIs | prozac
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| Name an atypical antidepressant? | Bupropion
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| What are atypical antidepressants used for? | Depression & smoking cessation
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| What are AE for atypical antidepressants? | agitation, headache, dry mouth, constipation, weight loss, gi upset, blurred vision.
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| What is the most serious AE for Bupropion? | seizures
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| What may be considered a benefit AE for Bupropion? | increased sexual desire
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| How do MAOIs work? | Normally MAO converts NE, dopamine & serotonin into inactive products; if this is inhibited the amount of NE & serotonin increases
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| What are MAOIs used to tx? | atypical depression-- is usually 2nd/3rd choice; OCD, bulimia
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| What is the most severe AE that can occur w/ MAOI? | Hypertensive crisis
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| What must patients on MAOIs avoid in their diet? | Foods containing tyramine--avocados, bananas, chocolate, cheese etc..
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| 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
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| True/ False: MAOIs are beneficial for suicidal patients? | F
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| 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
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| What disorder is Lithium used to tx? | manic phase of bipolar
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| What are AEs that occur at therapeutic levels w/ Lithium? | Nausea, vomiting, diarrhea, slurred speech, muscle weakness, thirst, polyuria
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| What are toxic AE of lithium? | Seizures, hypotension, stupor, death
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| Why must lithium levels be monitored? | narrow therapeutic index
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| 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.
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| What must be monitored when patients are taking Lithium? | Na+ levels, I& O, renal function, and lithium plasma levels.
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| What must be taught to patients who take lithium in regards to their diet? | Have constant diet of Na+ intake .
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