Antidepressants Flashcards
Describe the mechanism of action (how it works) of MAOIs
Prevents the destruction of ALL monamines, causing levels to rise
List 3 monoamines
Serotonin
Dopamine
Norepinephrine
Examples of MAOIs are
isocarboxazid
phenelzine
selegiline
tranylcypromine
Why should clients avoid tyramine while taking an MAOI?
Consuming tyramine can cause a severe hypertensive crisis that could lead to stroke or death
Monoamine oxidase
enzyme that destroys monoamines
Give examples of food/drinks that contain tyramine
Aged cheese meats wine (Chianti) liver avocado
What are some serious MAOI drug interactions?
OTC cold medications
other antidepressants
meperidine
How does serotonin syndrome develop?
this occurs when you take a medication that cause high levels of serotonin to accumulate in your body
What are some signs and symptoms of serotonin syndrome?
headache seizures fever increased hr and bp diarrhea twitching muscles,rigidity, loss of muscle coordination confusion/agitation
What is the mechanism of action (how it works) of TCAs?
they block the reuptake of norepinephrine and serotonin
List 4 examples of TCAs
amitriptyline
clomipramine
imipramine
nortriptyline
The more neurotransmitters you mess with, the more ____ _____
side effects
Why aren’t TCAs the first line of treatment for depression anymore?
TCAs are considered “dirty” drugs with several side effects and there are now safer alternatives such as SSRIs
Identify ways to reduce dry mouth
sugarless candy/lozenges
artificial saliva
TCAs also block the action of
Histamine
Acetylcholine (Cholinergic)
If Acetylcholine is blocked, what side effects would you expect to experience?
Cant see, spit, pee, defecate
If Histamine is blocked, what side effects would you expect to experience?
drowsiness
Taking too much of a TCA can cause
death
Adverse effects such as dry mouth, blurred vision, urinary retention, constipation, sedation, orthostasis occur because
TCAs block the reuptake of norepinephrine and serotonin as well as the receptors for histamine and acetylcholine
Describe the mechanism of action of SSRIs
they selectively block the reuptake of only seretonin
List 4 examples of SSRIs
fluoxetine
paroxetine
fluvoxamine
sertraline
According to the SSRI black box warning, what age group is most likely to experience idealization of suicide?
patients under the age of 18
According to the SSRI black box warning, what age group is less likely to experience idealization of suicide?
patients over the age of 65
What is the mechanism of action of NRIs?
they block the reuptake of norepinephrine
Give an example of an NRI
altomoxetine
What is altomoxetine approved by the FDA to treat?
ADHD
The higher the dose of mirtazapine, the less ______ it is
sedative
Atypical antidepressants
bupropion
trazadone
mirtazapine
When taking the SNRIs Effexor or Pristiq, you must monitor
blood pressure
MAOIs are first choice drugs for what patients?
Those with atypical depression
