Psych Drugs - Antidepressants

Front 1

what is the action of anti-depressant medications

Back 1

Increase or enhance Norepinephrine & serotonin activity through blocking the reuptake process or acting as an antagonist to neurotransmitters or blocking receptors.

Front 2

things to teach patients about antidepressants

Back 2

antidepressants don’t work PRN - instruct to take as directed.
Encourage pt if they experience s/e rather than stop med, talk to Dr. may need to switch when taken (sedation, for ex).
Some cause performance problems in males. Can switch med if this is a problem.
THEY HAVE A DELAYED ANTIDEPRESSANT EFFECT – 2-4 WEEKS TO FEEL FULL EFFECTS OF MED.

Front 3

list some common tricyclic antidepressants

Back 3

Elavil
Anafranil (OCD)
Pamelor
other less common tricyclics include:
Asendin, Norpramin, Sinequan, Tofranil, Ludiomil, Pamelor, Vivactil

Front 4

older classification of antidepressants that increase norepinepherine in synaptic cleft

Back 4

tricyclics

Front 5

classification of antidepressants that have serious sometimes fatal side effects from overdose

Back 5

tricyclics

Front 6

what can happen if a bipolar patient is taking tricyclic antidepressant

Back 6

it can stimulate a mania

Front 7

common side effects of tricyclics, SSRIs, SSNRIs, and other antidepressants (except for MAOI's)

Back 7

drowsiness, constipation, orthostatic hypotension, tremors, EKG changes & arrhythmias, can aggravate glaucoma, lower seizure threshold. Use cautiously in elderly – confusion, urinary retention.

Front 8

which classification of antidepressants are of special concern for elderly due to increased confusion and risk for falls due to orthostatic hypotension

Back 8

tricyclics

Front 9

SSRI stands for

Back 9

selective serotonin reuptake inhibitors

Front 10

side effects of SSRI's

Back 10

less lethal in OD. Taken w/food in am typically. Don’t usually cause sedation. Headache, more nervousness, difficulty sleeping, decr appetite, weight loss, GI upset, N/V/D, abnormal disturbing dreams, risk for serotonin syndrome

Front 11

what causes serotonin syndrome

Back 11

taking more than one or overdosing on SSRIs and/or SSNRIs

Front 12

signs of serotonin syndrome include

Back 12

hypertension, fever, or hypotension, agitated, shivering, D/N, hypersalivation, abd pain, mental status changes – confusion

Front 13

common SSRI's include

Back 13

Celexa, Lexapro, Prozac, Sarafem, Luvox, Paxil & Zoloft

Front 14

common SSNRI

Back 14

Cymbalta

Front 15

other anti-depressants include: these have similar side effects of SSRI's

Back 15

wellbutrin, remeron, Desyrel and Effexor

Front 16

how to discontinue taking antidepressant medications

Back 16

gradually or will get withdrawl syndrome (dizziness, sweating, headache, nausea, anxiety, fatigue, visual disturbances, rebound depression or hypomania)

Front 17

antidepressant known to cause priaprism

Back 17

trazodon (Deseryl)

Front 18

why are MAOI's typically the last class of antidepressants to be tried?

Back 18

need to follow tyramine-free diet because of possibility of causing hypertensive crisis

Front 19

3 MAOI's

Back 19

Nardil, Parnate & Ensam (patch)

Front 20

side effects of MAOI's

Back 20

weight gain, anticholinerigc effects – dry mouth, constipation, ortho hypotension, disturbed sleep patterns, usually not given to people with CVA, chest pain, heart failure, precaution is that they must follow special diet - Can cause hypertensive crisis

Front 21

tyramine free diet foods include

Back 21

Beer, wine (reds esp), caffeine, cheeses (aged, hard), processed meats, liver, sauerkraut, bananas, avocados, plums, pineapples, papayas, canned figs, raisins, MSG, licorice, pickles, soy sauce, chocolate

Front 22

medications that can cause hypertensive crisis in pt's taking MAOIs

Back 22

OTC cold remedies, diet pills, local anesthetics

Front 23

how long must a patient follow diet restrictions for after stopping MAOIs

Back 23

10 days

Front 24

are sedation & weight gain, orthostatic hypotension & anticholinergic effects more common with SSRIs or TCAs/MAOIs?

Back 24

TCAs/MAOIs

Front 25

Signs of hypertensive crisis to report to Dr or go to ER

Back 25

start feeling palpitations, stiff neck, chest pain, headache, especially severe.