Antidepressant Meds: Med Overview Flashcards
MAOIs
Drugs
Isocarboxazid
Tranylcypromine sulfate
Phenelzine sulfate
MAOIs
Adverse Effects
Postural Hypotension
If foods with tyramine ingested, can have HYPERTENSIVE crisis: headache, sweating, palpitations, stiff neck, intracranial hemorrhage.
potentiates alcohol and other meds.
MAOIs
Nursing Considerations
Inhibits monoamine oxidase enzyme, preventing destruction of norepinephrine, epinephrine, and serotonin. Avoid foods with tyramine- aged cheese, liver, yogurt, herring, yest, beer, wine, sour cream, pickled products. Avoid caffeine, antihistamines, amphetamines. Takes 3-4 weeks to work. Avoid tricyclics until 3 weeks after stopping MAO inhibitors. Monitor vital signs. Sunblock required.
MAOIs
No Popular Meds…
Nardil (phenelzine), Parnate ( Tranylcypromine) , Marplan (Isocarboxazid).
NO Barbiturates, Meperidine ( demerol), Tricyclic and SSRI antidepressants, antihistamines, CNS depressants, Antihypertensives, OTC medications- cold remedies, asthma medications, nasal decongestants.
NO Avocados, cheese, wine, aged meats, smoked fish
Tricyclics
( think tricycles)
Drugs
Amitriptyline hydrochloride, Imipramine, Desipramine hydrochloride, doxepin, Nortriptyline.
Tricyclics
Adverse Effects
Sedation/ drowsiness, especially w Elavil ( amitriptyline ), blurred vision, dry mouth, diaphoresis, postural hypotension, palpitations, nauseous, vomiting, constipation, urinary retention, increased appetite.
Tricyclics
Nursing Considerations
Increased brain amine levels, Suicide risk high after 10-14 days because of increased energy. Monitor vital signs, sunblock required, increased fluid intake, take dose at bedtime ( sedative effect), use sugarless candy or gum for dry mouth, delay of 2-6 weeks before noticeable effects.
Tricyclics
Alert/ watch for signs
When depressed patients begin to feel better after starting meds, they are at increased risk of suicide.
Watch for signs of: sedation, orthostatic hypotension, dec sexual ability/desire, dry mouth, urinary retention, cardiac dysrhythmias.
Selective serotonin reuptake inhibitors ( SSRIs)
SNRIs ( Serotonin-norepinephrine reuptake inhibitors)
Drugs
SSRIs- fluoxetine, paroxetine, sertraline hydrochloride, citalopram.
SNRIs- Venlafaxine, Duloxetine
Selective serotonin reuptake inhibitors ( SSRIs)
SNRIs ( Serotonin-norepinephrine reuptake inhibitors)
Adverse Effects
Palpitations, bradycardia. Nausea, vomiting, diarrhea or constipation, increased or decreased appetite. Urinary retention. Nervousness, insomnia.
Selective serotonin reuptake inhibitors ( SSRIs)
SNRIs ( Serotonin-norepinephrine reuptake inhibitors)
Nursing Considerations
Decreases neuronal uptake of serotonin. Take in AM to avoid insomnia. Takes at least 4 weeks to work. Can potentiate effect of digoxin, warfarin, and diazepam. Used for anorexia.
Heterocyclics/ Atypical
Drugs
Bupropion
Trazodone
Heterocyclics/ Atypical
Adverse Effects
Dry mouth
Nausea
Heterocyclics/ Atypical
Nursing Considerations
May require gradual reduction before stopping. Avoid use with alcohol, other CNS depressants for up to 1 week after end of therapy.
Herbals
Drugs
Adverse Effects
Drug: St John’s Wort
Dizziness, hypertension, allergic skin reaction, phototoxicity.
Herbals
Nursing Considerations
Avoid use of St. john’s Wort and MAOI within 2 weeks of each other. Do not use alcohol. Contraindicated in pregnancy. Avoid exposure to sun and use sunscreen.
Discontinue 1 to 2 weeks before surgery.
Herbal Interactions
St John’s wort- interacts with SSRIs; do not take within 2 weeks of MAOI.
Ginseng may potentiate MAOIs. Avoid Ma huang or ephedra with MAOIs.
Kava Kava should not be combined with benzodiazepines or opioids due to increased sedation.
Increase use of brewer’s yeast with MAOIs can increase blood pressure.
