Tricylics - Antidepressant Drugs

Front 1

Anti-depressant medication categories in order of origin:

Back 1

MAO Inhibitors
Tricylic Anti-D's
SSRI

Front 2

Tricyclics work by inhibiting the uptake of ________ and _______.

Back 2

Norepinephrine and/or serotonin

Front 3

Tricyclics relieve symptoms of _______ and ________ depression

Back 3

Severe and mild

Front 4

Tricyclics treat depression with _____ and ________ causes.

Back 4

Endogenous and exongenous

Front 5

What's so special about the overdosage symptoms of Tricyclics?

Back 5

CNS overstimulated --> CNS depression.

Front 6

What would be the s/s of an tricyclic overdosed pt suffering from an overstimulated CNS?

Back 6

4 H's
Hypertension
Hyperpyrexia
Hypertonia
Hyperrflexia

Front 7

A pt presents to the nurse's station. They are quite agitated and 'twitchy'. This could be a sign of _____?

Back 7

Tricyclic Overdose symptoms.

CNS stimulation. The initial stage. The patiest may also hallucinate and show signs of nystagmus. Seizures are common in children.

Front 8

A pt appears to be suffering from CNS depression, the result of a tricylic overdose. What does this look like?

Back 8

Hypothermia
Hypoflexia (areflexia)
Hypotension

Front 9

Respiratory depression and cardiac dysrhythmias are s/s of _______.

Back 9

A tricyclic overdose

CNS stimulation

Front 10

Postural hypotension, headaches and drowsiness that lasts a long time are s/s of _________.

Back 10

An Adverse Reaction to Tricyclics

Front 11

What problems might an individual suffering an adverse reaction to Tricylics have with their 'plumbing'?

Back 11

Urinary retention or hesitancy and constipation.

Front 12

Blurry vision and altered LFT's are s/s that may demonstrate __________.

Back 12

An Adverse Reaction to Tricyclics

Front 13

Tricyclics tend to ________ the depressant effect of alcohol and other CNS depressants?

Back 13

Increase.

Especially the drug ethchlorvynol

Front 14

How do tricyclics affect anticonvulsants?

Back 14

They decrease the effect of anticonvulsants.

Front 15

What happens when tricyclics are mixed with MAO I's?

Back 15

Severe hypertension and hyperpyrexia

Front 16

What is hyperpyrexia?

Back 16

High temperature.

Front 17

Is it probably not wise to give Tricyclics to pts with a history of:

Back 17

G laucomo
R enal/Hepatic failure
a
M I

Front 18

What happens with manic-depressives are given antidepressants?

Back 18

They go 'manic'.

Front 19

Those with schizophrenia and bipolar disorder taking antidepressants tend to demonstrate s/s of:

Back 19

Exaggerated signs of paranoid ideation and schizophrenia

Front 20

How does the health care provider treat the biopolar or schizophrenic pt showing exaggered effects due to antiD administration?

Back 20

Lower dose or add a tranq

Front 21

Should you give antidepressants to a suicidal pt?

Back 21

Only a small and reasonable amt.

Front 22

What would the tricyclic antidepressant dosage be based upon?

Back 22

Age, health, status and response to the drug.

...b/c plasma concentrations vary wildly and may not correspond w/dosage and therapeutic effect.

Front 23

Why are Tricyclic antidepressants started with a bedtime dose?

Back 23

The initial dose causes sedation.

Some tricyclics are known to have strong sedative effects.

Front 24

How soon after taking tricylics can the pt expect to feel better?

Back 24

1 to 4 weeks

...but it may take up to 8 weeks before the patient begins to feel better.

Front 25

If necessary, how should the tricyclic must be stopped?

Back 25

Gradually, reducing symptoms over 4- 8 weeks

Front 26

When taking tricyclics, a pt should inform their hlth care provider when ______.

Back 26

Drowsiness and decreased alertness last longer than 2 weeks.

Front 27

Your pt must have surgery. It is safe to keep them on Tricyclics. T or F

Back 27

FALSE

Tricyclics are usually halted days before surgery.

Front 28

A maintenance dose, administered in divided or single bedtime doses, may be continued for ____ to ____

Back 28

6 months to 1 year

Front 29

If necessary, how should the tricyclic must be stopped?

Back 29

Gradually, reducing symptoms over 4- 8 weeks

Front 30

When taking tricyclics, a pt should inform their hlth care provider when ______.

Back 30

Drowsiness and decreased alertness last longer than 2 weeks.

Front 31

Your pt must have surgery. It is safe to keep them on Tricyclics throughout postop. T or F

Back 31

FALSE

Tricyclics are usually halted days before surgery.

Front 32

A maintenance dose, administered in divided or single bedtime doses, may be continued for ____ to ____

Back 32

6 months to 1 year

Front 33

Why are MAO i's and Tricylcics not used together?

Back 33

Hyperpyrexia, convulsion and hypertensice crisis may result

Front 34

Foods with more that ___mg of _____ per serving must be avoided.

Back 34

6 mg of tyramine

Front 35

What types of foods must be avoided for MAOI's?

Back 35

Sausage
Sauerkraut
Soy
Sour Cream

Front 36

What types of dairy can the pt taking MAO I's not have?

Back 36

Cheese
Yogurt
Sour cream

Front 37

What sorts of fruit may the pt on MAO I's not have?

Back 37

Bananas
Avocados
Raisins
Figs

Front 38

Pt's on MAO I's may use caffeine products liberally? T or F

Back 38

FALSE

Limit tea, cola and chocolate.

Front 39

Why would the pt on MAO I's abstain from highly caffeinenated foods?

Back 39

They can cause hypertension and dysthrythmias

Front 40

A pt taking MAO I's and ingesting large amounts of herring or cheese is R/F __________.

Back 40

Sudden/severe hypotension

...these are high in tyramines.

Front 41

Name two MAOI drugs

Back 41

GENERIC TRADE

Phenelzine Nardil
Tranylcypromine Parnate

Front 42

What is hyperemesis Gravidarum

Back 42

Severe nausea + vomiting