Antidepressant Agents Flashcards
Define affective disorder
A person’s mood goes far beyond the usual, normal “ups and downs”
Define depression
Severe and long-lasting feelings of sadness beyond what was the precipitating event
What are the signs and symptoms of depression?
Low energy level Sleep disturbances Lack of appetite Limited libido Inability to perform ADLs Overwhelming feelings of sadness, despair, hopelessness and disorganization
Actions of antidepressant therapy
Depression results from a deficiency of NE, dopamine, and 5HT (serotonin)
What are the classifications of antidepressants?
Tricyclic Antidepressants (TCAs)
MAO inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin/NE Reuptake Inhibitors (SNRIs)
What are the actions of tricyclic antidepressants?
Reduce reuptake of 5HT and NE
What are the indications of tricyclic antidepressants?
Relief of symptoms of depression
Used w/ patients with sleep disorders
Treatment of enuresis (bed wetting)
Chronic pain
Tricyclic antidepressants are taken at bedtime?
True
Pharmacokinetics of tricyclics
Absorbed from GI track
Bound to plasma proteins and lipid soluble
Metabolized in the liver
Excreted in the urine
Contraindications of tricyclics
Allergy, recent MI, myelography, pregnancy, lactation
Cautions for tricyclics
CV disease, angle closure glaucoma, urinary retention, manic-depression
What are the adverse effects of tricyclics
Sedation, sleep disturbances, fatigue, hallucinations, ataxia, dry mouth, constipation, nausea, vomiting
Tricyclic drug-drug interactions
MAOIs, cimetidine, fluoxetine, ranitidine, oral anticoagulants
Tricyclic antidepressants have a black box warning?
True
What are the Tricyclic antidepressant agents?
Amitriptyline (Elavil)
Doxepin (sinequan)
Imipramine (tofranil) - bed wetting
