ANTIDEPRESSANT AND MOOD STABILIZERS Flashcards

1
Q

Major depressive disorder

A

Depression

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2
Q

A mood disorder that causes a persistent feeling of sadness and loss of interest

A

Depression

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3
Q

Depression is the most common mental health disorder of elderly adults, encompassing a variety of

A

physical, emotional, cognitive and social considerations

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4
Q
  • Lack of energy, extremely tired
  • Abnormal eating patterns, feeling of despair
    -Guiltiness and hopelessness and misery
  • Sleep disturbance like difficulty sleeping or too much sleep
  • Vague physical symptoms (Gl pain, joint/muscles pains or headaches)
  • Obsessed with death (expressing a wish to die or to commit suicide)
  • Lack of interest in personal appearance or sex Delusion or hallucinations
A

S/Sx associated w/ depression

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5
Q

Sudden onset after the precipitating event

A

Reactive depression

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6
Q

Sometimes called manic depression, has mood episodes that range from extreme of high energy with an “up” mood to low “depressive” periods. Swings between two moods - euphoric and dysphoric

A

Bipolar disorder

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7
Q

Loss of interest to work and even at home and inability to complete tasks. Difficult to study, sleep, eat and enjoy friends and activities

A

Major depression

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8
Q

help clients gain insight into and resolves their problems through verbal “give - and - take” with the therapy’s Interpersonal therapies

A

Counseling therapies

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9
Q

help the client change the negative styles of thought and behavior that are often associated with their depression

A

Cognitive behavioral therapies

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10
Q

focuses on the clients disturbed personal relationship that both cause and exacerbate the depression

A

Interpersonal therapies

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11
Q

focus on resolving the client’s internal conflicts

A

Psychodynamic therapies

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12
Q

A medical treatment for clients with serious and life-threatening mood disorders that are unresponsive to pharmacotherapy and often used treatment for depression that is hard to treat.

A

ELECTROCONVULSIVE THERAPY (ECT)

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13
Q

Effective somatic treatment for major depression

A

REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS)

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14
Q

Treat major depression by enhancing mood

A

ANTIDEPRESSANT

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15
Q

Antidepressant is often prescribe to

A

phobia, OCD, panic, and anxiety

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16
Q

Beneficial in treating psychological and physical signs of pain, especially in clients without major depressive disorder

A

Antidepressant

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17
Q

the most important warning about antidepressants. This should be included at the beginning of drug package inserts and drug information sheets. This warning to applies to children who are at risk for suicidal ideation.

A

Black box warning

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18
Q

WHAT ARE THE FOUR PRIMARY CLASSES OF ANTIDEPRESSANT DRUGS?

A
  1. Tricyclic antidepressants (TCAs)
  2. Selective serotonin reuptake inhibitors (SSRIs)
  3. Monoamine oxidase inhibitors (MAOIs)
  4. Atypical antidepressants including the serotonin norepinephrine reuptake inhibitors (SNRIs) and other atypical antidepressants
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19
Q

They inhibit the reabsorption of serotonin and norepinephrine and elevate mood by increasing the level of serotonin, norepinephrine, and dopamine in the central nervous system

A

Duloxetine (Cymbalta)
Venlafaxine (Effexor)

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20
Q

Inhibit the reuptake of both norepinephrine and serotonin into presynaptic nerve terminals and is used mainly for major depression and occasionally for milder situational depression

A

TRICYCLIC ANTIDEPRESSANTS

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21
Q

Example of TCAs

A

Amitriptyline (Elavil)
Amoxapine (Asendin)
Imipramine (Tofranil)

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22
Q

Used for treatment of childhood enuresis

A

CLOMIPRAMINE (ANAFRANIL)

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23
Q

What is enuresis

A

Bedwetting

24
Q

CLOMIPRAMINE (ANAFRANIL) is approved treatment for ______

A

OCD

25
Q

Most common side effect of TCA’s

A

Orthostatic hypotension

26
Q

The most serious adverse effect of TCA’s

A

Cardiac dysrhythmias

27
Q

Therapeutic effects of TCAs may take how many weeks to occur?

A

2 to 4

28
Q

_____ is contraindicated in clients in the acute recovery phase of an MI, with heart block or with history of dysrhythmias, because of their effects on cardiac tissue

A

TCAs

29
Q

Clients with urinary retention, narrow angle glaucoma or prostatic hypertrophy may not be good candidates for TCAs because of

A

anticholinergic side effects.

30
Q

are pregnancy category C or D, so they are used during pregnancy or lactation only when medically necessary

A

Most TCAs

31
Q

may decrease the efficacy of tricyclics

A

Oral contraceptive

32
Q

Does smoking a cigarette diminishes the effects of TCAs

A

Yes

33
Q

it will increase the rate of TCAs metabolism and excretion

A

Carbamazepine (Tegretol), Phenytoin (Dilantin), and rifampin (rifadin)

34
Q

Does Tricyclic affect the efficacy of clonidine (catapres) and guanethidine (Ismelin)?

A

Yes

35
Q

In TCAs, ________ interferes with their metabolism and excretion

A

Cimetidine (Tagamet)

36
Q

Be aware that it may take _______ to achieve the full therapeutic effect of the drug (TCAs)

A

several weeks or more

37
Q

What do SSRIs stand for?

A

SELECTIVE SEROTONIN REUPTAKE INHIBITORS

38
Q

Drugs that slow the reuptake of the serotonin into presynaptic nerve terminals

A

SSRIs

39
Q

SSRIs are the drug of choice in the treatment of _____ because of their favorable side effect profile

A

depression

40
Q

Its function is to increase level of serotonin in the synaptic gap induce complex neurotransmitter changes in presynaptic and postsynaptic neurons in the brain. Presynaptic receptors become less sensitive and postsynaptic receptor become more sensitive.

A

SSRIs

41
Q

SSRIs treat the following:

A

Major depression
OCD
Panic, phobias, PTSD

42
Q

DRUG EXAMPLES OF SSRIs

A

Citalopram (Celexa)
Escitalopram oxalate (Lexapro)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)

43
Q

Is a natural neurotransmitter in the CNS, found in high concentrations in certain neurons in hypothalamus, limbic system, medulla and spinal cord.

A

Serotonin

44
Q

Is important to several body activities including the cycling between ______ and ____, ______and ____

A

NREM and REM sleep
pain perception and emotional states

45
Q

Its chemical name is 5-hydorxytryptamine (5-HT)

A

Serotonin

46
Q

Most common side effects of SSRIs

A

Sexual dysfunction

47
Q

A rare but serious disorder that affects the skin, mucous membrane, genitals and eyes

A

Steven-Johnson syndrome

48
Q

Steven-Johnson syndrome is usually caused by an ________

A

unpredictable adverse reaction to certain medications

49
Q

May occur when the client is taking in another medication that affects the metabolism, synthesis or reuptake of serotonin, causing serotonin to accumulate in the body

A

Serotonin syndrome

50
Q

SES symptoms can begin as early as_____ after taking the first dose or as late as several weeks after the initiating pharmacotherapy

A

2 hours

51
Q

Mental status changes (confusion, anxiety, restlessness)
Hypertension, tremors
Sweating, hyperpyrexia, or ataxia

A

S/Sx of SES

52
Q

Note a history of_______, because SSRIs commonly cause weight gain, which may contribute to noncompliance in clients with distortions and concerns about body image

A

eating disorders

53
Q

Ask the client about suicidal ideation, because the drugs may take______ before full therapeutic benefit is obtained

A

several weeks

54
Q

SSRIs may take up to_____ to reach their maximum therapeutic effectiveness

A

5 weeks

55
Q

Take most SSRIs in the _____ with food to avoid GI upset and insomnia.

A

morning

56
Q

______ and ____maybe taken in the morning and evening

A

Lexapro and Zoloft

57
Q

Take _____ at bedtime because it usually causes excessive drowsiness, especially at lower dose

A

Rameron