Antidepressants

Question 1

MAOIs: what are they?

Answer 1

Isocarboxazid, Tranylcypromine sulfate, Phenylzine sulfate!

Question 2

MAOIs: action?

Answer 2

interferes with monoamine oxidase, allowing for increased CONCENTRATION OF NEUROTRANSMITTERS which allows for stabilization of mood!

Question 3

MAOIs: side effects

Answer 3

HYPERTENSIVE CRISIS: if taken with foods containing TYRAMINE (aged cheese/processed meats/bananas/figs/raisins/BEER/CHIANTI) or epinephrine/norepinephrine (OTC meds!)
photosensitivity! Just like tetracyclines!
weight gain, sexual dysfunction (ugh) and orthostatic hypotension (also ugh)

Question 4

MAOIs: nsg considerations

Answer 4

DON’T TAKE WITH SSRIs also this isn’t the first line of drugs.. avoid other CNS depressants and be careful with antihypertensives,
Getting surgery? D/C 10 DAYS BEFORE GEN. ANESTHESIA!
Also- give meds to lower seizure threshold! It also might cause urinary retention because we don’t already have enough problems!

Question 5

SSRIs + SNRIs

Answer 5

fluoxetine, paroxetine, sertraline hydrochloride (these are the SSRIs);
citalopram, venlafaxine, duloxetine (these are the SNRIs)

Question 6

Selective Reuptake Inhibitors: action

Answer 6

inhibits CNS neuronal uptake of serotonin; acts as STIMULANT counteracting depression and INCREASES MOTIVATION!

Question 7

Selective Reuptake inhibitors: indicated for?

Answer 7

depression, OCD, obesity and bulemia

Question 8

MAOIs: indicated for?

Answer 8

chronic pain syndromes, depression.

Question 9

SSRIs/SNRIs: side effects?

Answer 9

headache and dizziness, nervousness, insomnia, dorwsiness, anxiety, tremor, dry mouth (!) gi upset (you knew that one) taste changes, rash, sweating, URI, painful menses, WEIGHT GAIN

Question 10

SSRIs/SNRIs: nursing considerations

Answer 10

take in the AM! requires 4 WEEKS FOR FULL EFFECT
monitor weight, good mouth care! MOUTH CARE
MOUTH CARE
MOUTH CARE BECAUSE YOU WILL HAVE A DRY ASS MOUTH
risk of SEROTONIN SYNDROME if given with MAOIs
monitor for THROMBOCYTOPENIA, LEUKOPENIA AND ANEMIA!!
ugh so many thingggs

Question 11

Tricyclics: Amitryptyline, imipramine

IMIPRAMINE IS ONE OF THESE IT IS A TRICYCLIC

Answer 11

acts on NOREPI and SEROTONIN; also has ANTICHOLINERGIC ACTIONS peripherally + on CNS

Question 12

Tricyclics: Indicated for?

Answer 12

Depression and OBSTRUCTIVE SLEEP APNEA

Question 13

Tricyclics: side effects:

Answer 13

Anticholinergic effects: dry mouth + blurred vision; confusion (ESP IN ELDERLY) photosensitivity (OMG JUST LIKE MAOIs AND I KNOW THIS NOW)
also orthostatic hypotension and urinary retention (JUST LIKE SSRIs!) aaaaand bone marrow depression :(

BUT side effects will decrease over time!!

Question 14

Tricyclics: Nursing Considerations

Answer 14

May not be effective for 1-3 weeks, full effect = 6-9 weeks
when to give? DAILY DOSE AT NIGHT to decrease side effects during the day.
DO NOT STOP TAKING ABRUPTLY or else you will have HEADACHE VERTIGO NIGHTMARESSSSS MALAISE WEIGHT CHANGE.
rull bad

Question 15

Heterocyclics: what are these?

Answer 15

Bupropion and Trazodone!

Question 16

Heterocyclics - action?

Answer 16

alters the effects of serotonin on the CNS

Question 17

Heterocyclics: indications?

Answer 17

smoking cessation and depression

Question 18

heterocyclics: side effects?

Answer 18

nausea and dry mouth;
trazodone = sedation and orthostatic hypotension
bupropion = insomnia and agitation

Question 19

heterocyclics: nursing considerations

Answer 19

may require gradual tapering to stop, don’t mix with other CNS depressants.