Antidepressants

Question 1

3 neurotransmitters implicated in depression

Answer 1

Serotonin
Dopamine
Noradrenaline/ Norepinephrine

Question 2

S&S of Depression

Answer 2

Persistent low mood
loss of pleasure in usual activities
fatigue
changes in sleep habits
difficulty in concentration

Question 3

Aetiology (cause) of depression

Answer 3

stressful events
physical illness
genetics
social isolation
trauma

Question 4

what antidepressants do

Answer 4

bring neurotransmitters (serotonin, dopamine and noradrenaline) normal level in the body

Question 5

how long antidepressants benefits can be observed and what are noticeable changes

Answer 5

up to 8 weeks
improvement in sleep, appetite and motivation

Question 6

neurotransmitter found in the brain made by amino acid trytophan. Contributes to feeling of wellbeing and happiness

This is also 90% found in the GI tract, increases gastric and colonic motility, nausea, vasoconstriction and platelet aggregation

Answer 6

Serotonin

Question 7

5- hydroxytryptamine (5-HT) is a monoamine neurotransmitter also called as

Answer 7

Serotonin

Question 8

Monoamine oxidase (MAO) enzyme catalyses or breakdown which neurotransmitters?

Answer 8

Serotonin (5-HT)
Dopamine
Noradrenaline

Question 9

4 classes of Antidepressant drugs

Answer 9

SSRI/ Selective Serotonin Reuptake Inhibitors
SNRI/ Serotonin and Noradrenaline Reuptake Inhibitors
Tricyclic Antidepressants (TCA)
Monoamine oxidase inhibitor (MAOI)

Question 10

Pharmacodynamics of SSRI and SNRI

Answer 10

Inhibit reuptake pumps for serotonin and noradrenaline

Question 11

Temporary or transitory adverse effects of SSRIs and SNRIs

Answer 11

Dizziness, confusion, disorientation, increased anxiety
Nausea
Sleepiness
Suicidal thoughts (young people)

Question 12

Long term adverse effects of SSRIs and SNRIs

Answer 12

Tremor
Sexual dysfunction
Sweating
Hyponatraemia
Weight loss or gain
HTN and Tachy (SNRI)

Question 13

Pharmacodynamics of TCA (Tricyclic Antidepressants)

Answer 13

Serotonin and noradrenaline reuptake inhibitors
Histamine (inflammatory mediator for allergic reactions) and acetycholine (parasympathetic neurotransmitter) antigonist
Na and Ca channels inhibitors

Question 14

First line drug of depression and anxiety

Answer 14

SSRI (Selective Serotonin reuptake inhibitors)

Question 15

Major side effect of SSRI overdose

Answer 15

Serotonin Syndrome

Question 16

SSRI meds

Answer 16

Citalopram
Escitalopram

Setraline

Fluoxetine

Vilazodone

Question 17

Inhibits serotonin reuptake = increasing serotonin levels

Answer 17

SSRI

Question 18

Inhibits serotonin and noradrenaline or dopamine and noradrenaline reuptake

Answer 18

SNRI/ DNRI

Question 19

do not mix ________ with MAOIs or TCAs

Answer 19

SNRI and DNRI

Question 20

SNRI/ DNRI meds

Answer 20

Bupropion (used for smoking cessation)

Duloxetine

Venlafaxine

Milnacipran

Nefazodone

Question 21

Adverse effects of TCAs

Answer 21

Tremors
Cardio: Arrythmias, postural hypotension
Anticholinergics: dry mouth, dysphagia, constipation, urinary retention, palpitations
Sedation and seizures

Question 22

TCA meds

Answer 22

Amitriptyline
Nortriptyline

Doxepine

Clomipramine

Question 23

Blocks monoamine oxidase causing an increase in adrenaline, noradrenaline, dopamine and serotonin or increase in CNS stimulation

Answer 23

MAOI (Monoamine oxidase inhibitor)

Question 24

Adverse effects of MAOIs

Answer 24

Orthostatic hypotension (encourage pt to rise slowly)
Dizziness
Blurred vission

Constipation
Dry mouth
N&V

HTN crisis

Question 25

Foods to avoid while taking MAOIs

Answer 25

aged cheese fermented meats chocolate caffeinated beverages sour and cream yoghurt

Question 26

MAOI meds

Answer 26

Phenelzine Tranylcypromine Isocarboxazid

Question 27

Excess noradrenaline causes

Answer 27

anxiety aggression HTN

Question 28

deficient noradrenaline causes

Answer 28

depression lack of focus

Question 29

excess serotonin causes

Answer 29

headache confusion tachycardia HTN

Question 30

deficient serotonin causes

Answer 30

depression anxiety fatigue

Question 31

Nursing considerations for pts taking MAOIs

Answer 31

Up to 4 weeks therapeutic benefits Educate pt S&S of HTN crisis Avoid foods with Tyramine (aged cheese, fermented meats, chocolate, caffeinated beverages, sour cream and yoghurt)

Question 32

Nursing considerations for pts taking TCAs

Answer 32

up to 2- 3 weeks to see therapeutic benefits Wait for 2 weeks before starting TCAs after being off from MAOIs

Question 33

Nursing considerations for pts taking SSRI

Answer 33

up to 4-6 weeks efficacy Take meds during morning First line drug for depression and anxiety Pt (younger people) can be suicidal as they have the energy to plan

Question 34

Nursing considerations for SNRI

Answer 34

up to 4-6 weeks efficacy DO NOT MIX WITH TCAs and MAOIs DO NOT use it with Zyban (meds for smoking cessation) cause overdose