Drug Class - Antidepressants

Front 1

What are antidepressants used for?

Back 1

treatment of various forms of endogenous depression , often in conjunction with psychotherapy

Front 2

Some other uses (7) for antidepressants are and the names of the antidepressants that treat the uses are?

Back 2

anxiety treatment (doxepin)
enuresis in children
(imipramine)
chronic pain syndromes
(amitriptyline, doxepin,
imipramine,
nortriptyline)
smoking cessation (bupropion)
bulimia (fluoxetine)
obsessive-compulsive disorder
(fluoxetine, sertraline)
generalized anxiety disorder
(venlafaxine, paroxetine)

Front 3

Define enuresis and which tricyclic antidepressant treats it in children?

Back 3

involuntary discharge of urine after the age at which bladder control should have been established in children

imipramine can treat this condition in children

Front 4

Many of the tricyclic antidepressants can treat (1) or have these properties (2)?

Back 4

1 chronic pain syndromes
2 have significant
anticholinergic
properties
(which explains many of
their side effects;
amitriptyline
amoxapine
doxepin
imipramine
nortriptyline
3 have significant sedative
properties

Front 5

Antidepressant activity is most likely due to preventing the reuptake of ______, ________, and _____ in presynaptic neurons, resulting in accumulation of these neurotransmitters.

Back 5

dopamine
norepinephrine
serotonin

Front 6

The MAJOR classes of antidepressants are?

Back 6

tricyclic antidepressants
selective serotonin reuptake
inhibitors

Front 7

The selective serotonin reuptake inhibitors are likely to cause?

Back 7

insomnia

Front 8

Contraindications for antidepressants are?

Back 8

hypersensitivity
narrow-angle glaucoma
pregnancy
lactation
immediately following MI

Front 9

Use antidepressants cautiously in older patients and those with pre-existing _______ disease.

Back 9

cardiovascular

Front 10

Elderly men with _______ enlargement may be more susceptible to urinary retention.

Back 10

prostatic

Front 11

What symptoms do the antidepressants with anticholinergic effects display?

Back 11

dry eyes
dry mouth
blurred vision
constipation

Front 12

Antidepressants require slow titration and onset of therapeutic response may be ____ to ___ weeks.

Back 12

2 to 4

Front 13

Which group of antidepressants may cause hypertension, tachycardia, and convulsions when used with MAO inhibitors?

Back 13

tricyclic antidepressants

Front 14

Which group of antidepressants may prevent therapeutic response to some antihypertensives?

Back 14

tricyclic antidepressants

Front 15

Which group of antidepressants may cause additive CNS depression with other CNS depressants?

Back 15

tricyclic antidepressants

Front 16

Which group of antidepressants that have sympathomimetic activity may be enhanced when used with other sympathomimetics?

Back 16

tricyclic antidepressants

Front 17

Which group of antidepressants that have anticholinergic activity may be enhanced when used with other drugs possessing anticholinergic properties?

Back 17

tricyclic antidepressants

Front 18

What may occur with concurrent use of MAO inhibitors and:

amphetamines
methyldopa
levodopa
domamine
epinephrine
norepinephrine
desipramine
imipramine
guanethidine
reserpine
vasoconstrictors
ingestion of tyramine-
containing foods?

Back 18

hypertensive crisis

Front 19

What 5 life-threatening symptoms may occur with meperidine or other opioid analgesics and MAO inhibitors?

Back 19

hypertension
hypotension
coma
convulsions
death

Front 20

What additive complication can occur when combining MAO's with antihypertensives or spinal anesthesia?

Back 20

additive hypotension

Front 21

What additive effect can occur with MAO's and insulin or oral hypoglycemic agents?

Back 21

additive hypoglycemia

Front 22

Which group (1) and which 2 drugs in the miscellaneous listing should not be used in combination with or within weeks of MAO inhibitors?

Back 22

1 selective serotonin reuptake inhibitors (SSRIs)

2 bupropion
venlafaxine

Front 23

Risk of adverse reactions using antidepressants may be increased by using which type of drugs?

Back 23

vascular headache suppressants

ex:
almotriptan
frovatriptan
rizatriptan
naratriptan
sumatriptan
zolmitriptan

Front 24

What assessments should the nurse monitor for?

Back 24

mental status and affect
suicidal tendencies, esp.
during early therapy
restrict amount of drug
available to patient

Front 25

TOXICITY AND OVERDOSE:
What are symptoms of hypertensive crisis which may be brought on by concurrent ingestion of MAO inhibitors and tyramine-containing foods?

Back 25

chest pain
enlarged pupils
nausea
nuchal rigidity
photosensitivity
severe headache
vomiting

Front 26

What is the treatment for hypertensive crisis?

Back 26

IV phentolamine (Regitine) which is an agent for pheochromocytoma and belongs to the pharmaceutical class alpha-adrenergic blockers

Front 27

Three potential nursing diagnoses?

Back 27

Coping, ineffective
individual
Injury, risk for
Knowledge deficit, related to
medication regimen

Front 28

Administer drugs that are sedating at bedtime to avoid excessive drowsiness during waking hours, and administer drugs that cause insomnia in the morning. Drugs that may cause insomnia include?

Back 28

SSRIs:
fluoxetine
fluvoxamine
paroxetine
sertraline


MAO inhibitors:
phenelzine
tranylcypromine

Front 29

Patient/Family teaching tips?

Back 29

Avoid alcohol and other CNS
depressants
Avoid OTC drugs.
Educate about hypertensive
crisis.
Dizziness and drowsiness may
occur
Educate about orthostatic
hypotension.
Notify doctor of constipa-
tion, dry mouth, urinary
retention.
Notify doctor of herbal
remedies.
Emphasize psychotherapy.

Front 30

If MAO inhibitors are discontinued, don't consume OTC drugs or foods and beverages with tyramine for at least 2 weeks or it may precipitate?

Back 30

hypertensive crisis

Front 31

Effectiveness of therapy can be demonstrated by? (4)

Back 31

resolution of depression
decrease in anxiety
control of bedwetting in
children over 6 yo
management of chronic neuro-
genic pain

Front 32

Name 5 groups of antidepressants?

Back 32

MAOIs
SSRIs
tetracyclic antidepressants
tricyclic antidepressants
miscellaneous

Front 33

Name 2 monamine oxidase inhibitors?

Back 33

phenelzine Nardil

tranylcypromine Parnate

Front 34

Name 5 SSRIs?

Back 34

citalopram Celexa

fluoxetine Prozac, Prozac Weekly, Sarafem

fluvoxamine Luvox, Faverin, Fevarin, Dumyrox

paroxetine Paxil, Paxil CR

sertraline Zoloft

Front 35

Name 1 tetracyclic antidepressant?

Back 35

mirtazapine Remeron, Remeron Soltabs

Front 36

Name 6 tricyclic antidepressants?

Back 36

amitriptyline {Apo-Amitriptyline}, Elavil, Endep, {Levate}, {Novotriptyn}

amoxapine Asendin, Asendis, Defanyl, Demolox, Moxadil

desipramine Norpramin, {Pertofane}

doxepin Sinequan, {Triadapin}, Zonalon

imipramine {Apo-Imipramine}, {Impril}, Norfranil, {Novopramine}, Tipramine, Tofranil, Tofranil PM

nortriptyline Aventyl, Pamelor

Front 37

Name 4 miscellaneous antidepressants?

Back 37

bupropion
Wellbutrin, Wellbutrin SR, Zyban

nefazodone Serzone

trazodone Desyrel, Trialodine, Trazon

venlafaxine Effexor, Effexor XR

Front 38

ACLS guidelines have recommended _______ NOT be used unless hyperkalemia, tricyclic antidepressant overdose, and/or preexisting metabolic acidosis is documented.

Back 38

bicarbonate