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5 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Monoamine Oxidase Inhibitors (MAOI) |
Action: Interferes with monoamine oxidase, allowing increase in concentration of neurotransmitters in synaptic space, stabilizing mood *MAO found in brain/ blood/ platelets/ liver/ spleen/ kidneys Indications: Depression, chronic pain syndrome *given if pt has not responded to other antidepressants and electroconvulsive therapy A/E: HTN crisis (see below), weight gain, sexual disfunction, orthostatic hypotension, restlessness, insomnia, dizziness, weakness/ lethargy, GI upset, dry mouth, peripheral edema, anticholinergic effects, CNS stimulation (anxiety, agitation, mania) Nursing care: not first line of drugs for depression, not taken with SSRI, admin antihypertensive meds with caution, avoid other CNS depressants, d/c 10 days before general anesthesia, decreases seizure threshold, monitor urinary retention, avoid caffeine/ antihistamines, takes 3-4 weeks to work, monitor BP, report headache/ neck soreness/ neck stiffness, orthostatic precautions, Medic-Alert card, not hs, *HTN crisis risk with: food containing tyramine (cheese, bologna, pepperoni, salami, figs, bananas, raisins, beer, wine, sour cream, herring, yeast, liver, yogurt, pickled products), OTC meds containing ephedrine or pseudephedrine, amphetamines, antidepressants, dopamine, epinephrine, norepinephrine, guanethidine, levodopa, methydopa, nasal congestants, reserpine, vasoconstrictors- Antidote: phentolamine IV |
Phenelzine sulfate, Isocarboxazid, Tranylcypromine |
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Selective Reuptake Inhibitors |
Action: inhibits CNS neuronal uptake of serotonin; acts as stimulant counteracting depression and increases motivation Indications: depression, OCD, obesity, bulimia, anorexia A/E: headache, dizziness, nervousness, insomnia, drowsiness, anxiety, tremor, dry mouth, GI upset, taste changes, sweating, rash, upper resp infection, painful menses, sexual dysfunction, weight gain, palpitations, bradycardia, nausea/ vomiting/ constipation/ or diarrhea, urinary retention Nursing Care: take in AM (avoid insomnia), 4 weeks for full effect, monitor weight, oral hygiene, not taken with MAOI (serotonin syndrome), monitor for thrombocytopenia/ leukopenia/ anemia, can potentiate digoxin/ warfarin/ diazepam |
SSRI: Fluoxetine, Paroxetine, Sertraline hydrochloride SNRI: Citalopram, Venlafaxine, Duloxetine *Serotonin: S- sleep, E- emotion, R- remember. Happy hormone |
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Tricyclics |
Action: inhibits reuptake of neurotransmitters norepi and serotonin Indications: depression, obstructive sleep apnea A/E: sedation, anticholinergic effects (especially older adults), confusion (elderly), photosensitivity, orthostatic hypotension, urinary retention, diaphoresis, cardiovascular disturbances (dysrhythmias), seizures (with buproprion), weight gain, anxiety/ restlessness/ irritability, decreased libido/ ejaculatory and erection disturbances Nursing care: 2-6 weeks for full effect, may be admin hs to promote sleep and decreased A/E during day, orthostatic hypotension precautions, may reduce antihypertensive agents effect, A/E decrease with time, anticholinergic precautions, dont d/c abruptly (headache, vertigo, nightmares, malaise, weight changes), avoid alcohol/ sleep-inducing drugs/ antihistamines/ OTC drugs, monitor suicide risk, monitor VS/ BMs/ liver and renal function if long-term, increase fluid intake, may reduce seizure threshold, concurrent use of MAOI can cause hypertensive crisis, risk of cardiac toxicity, |
Amitriptyline, Imipramine, Desipramine, Doxepin, Nortriptyline |
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Heterocyclics/ Atypicals |
Action: doesn't inhibit MAO; has some anticholinergic/ sedative effect, alters effects of serotoning on CNS Indications: depression, smoking cessation A/E: dry mouth, nausea, insomnia/ agitation (buproprion), sedation/ orthostatic hypotension (trazodone) Nursing care: ween off drug, avoid CNS depressants for 1 week after end of therapy |
Buproprion Trazodone |
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Herbal Therapy and Interactions |
St-John's Wort A/E: Dizziness, HTN, allergic skin reaction, phototoxicity. Nursing Care: avoid with MAOI within 2 weeks of each other, no alcohol, not when pregnant, avoid sun, d/c 1-2 weeks before surgery Interactions St-John's with MAOI and SSRI (have to be within 2 weeks of each other) Ginseng potentiates MAOI Avoid ma huang/ ephedra with MAOI Kava kava not combined with benzo/ opoids (increases sedation) Increased use of brewer's yeast with MAOI can increase BP |
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