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15 Cards in this Set
- Front
- Back
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What causes anxiety and depression |
Biochemical imbalance theory- imbalance of neurotransmitters *Dopamine *Norepinephrine *Serotonin *GABA (gamma-aminobutyric acid) |
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Benzodiazepines (-pam -lam) Largest class of anxiolytics Decrease GABA Fast acting |
Also treats *alcohol withdrawal *insomnia *muscle spasms *seizure disorder *adjuncts in anesthesia |
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Benzodiazepines (Contraindications) |
*allergy *glaucoma *pregnancy |
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Benzodiazepines (Adverse effects) |
*CNS depression (fall risks) *Hypotension *paradoxical reactions ( more likely in children and older adults w/dementia) * Addictive (use @ lowest effective dose & taper to discontinue use) |
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Benzodiazepines (Overdose) |
*Generally not life threatening if taken alone * severe reactions when taken w/alcohol or other CNS depressants *highly lipid soluble creating toxicity |
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Benzodiazepines (Toxicity and Antidote) |
S&S: *Somnolence (drowsiness) *Confusion *Coma *Respiratory depression
Antidote: Flumazenil |
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Benzodiazepines (Patient Teaching) |
*short term use *avoid caffeine & stimulant drugs *don't combine w/other benzos *Don't perform tasks that require alertness (smoking,driving) avoid alcohol and other depressant drugs |
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Buspirone (Non-benzo anxiolytic) Long term use Less addictive Take with food/slows GI tract No dependence;no withdrawal |
*Agonist activity at both serotonin and dopamine receptors *Not used as a prn med *Does not have sedative or addictive properties |
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Depression-anger, loss, saddness, frustration |
*Takes at least 3-6 weeks to get a therapeutic reaponse *May be used in conjunction with anxiolytics and/or antipsychotic drugs *many drug interactions *Higher risk for suicide in patients receiving antidepressants
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Antidepressants |
*Regulate mood affecting receptors of serotonin, norepinephrine, & dopamine *1st generation: MAOI & TCA * 2nd generation: SSRI, SNRI, & Atypical antidepressants *take 2-4 weeks before symptoms start to improve |
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TCA (Tricyclic Antidepressants) amitrptyline |
*oldest antidepressant *2nd line treatment *blocks retake of norepinephrine and serotonin * blocks acetylcholine receptors (used to treat enuresis for this reason) *also used for neuropathic pain & insomnia) *Elderly more likely to experience anticholinergic effects (confusion, orthostatic hypotension, and sedation.) *interacts with anesthetics (d/c days before and days after surgery) |
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TCA adverse effects |
*Typical- sedation, hypotension, cardiac dysthymias -anticholinergic symptoms: constipation & urinary retention * Overdose: -lethal, especially when taken with alcohol. -CNS depression and cardiovascular effects. (Tremmors, seizures ) -NO ANTIDOTE ( may use activated charcoal and/or sodium bicarbonate) |
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TCA (cont.) |
*Inhibits matebolsim of many other drugs *Don't take with MAOIs * Take @ bedtime due to sedation *Baseline and follow up ECGs *Takes weeks for full effects *Avoid activities where alertness is necessary |
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MAOI (Monoamine oxidase inhibitors ) Phenelzine and Selegiline transdermal Taken 3 times a day |
3rd line agents for treating depression *Adverse reactions: -more likely to cause hypertensive crisis - AE precipitated by foods containing tyramine (aged cheeses and meats, soy, sauerkraut...table16-7) -dysrythmias, diziness, sexual dysfunction, orthostatic hypotention -can't have elective surgery on this med -do not take with SSRI, weight reduction or OTC cold medications. |
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SSRI (Selective serotonin retake inhibitors) anxiety, OCD, and bulimia |
Fluoxetine *fewer side effects than TCAs *blocks reabsorption of serotonin Adverse effects *increase suicide risk when given to children and young adults *high GI symptoms and sexual dysfunction *some degree of CNS stimulation *Serotonin syndrome- fatal reaction; hypertensive crisis, hyperpyrexia, extreme agitation, seizures. *Do not take within 2 weeks of taking an MAOI *Fluoxetine can prevent codeine from working effectively |
