antidepressants Flashcards
when is initial response seen?
may be up to 12 wks
SSRIs
- Selective Serotonin Reuptake Inhibitors
- Most commonly prescribed
- Fluoxetine
Fluoxetine
- Produces CNS excitation
- Side effects: Serotonin syndrome, sexual dysfunction, insomnia, drowsiness
Serotonin syndrome
- begins 2-72 hrs after treatment
- altered mental status including agitation, confusion, hallucination
Drug interactions w/ Fluoxetine
anti platelet drugs and anti coagulants can increase risk of GI tract (Aspirin & Warfarin)
nursing actions for SSRIs
- should be discontinued gradually
- effects 1-4 weeks
SNRIs
Venlafazine & Duloxetine
Duloxetine (SNRI)
adverse effects: nausea, dry mouth, orthostatic hypotension
TCA
adverse effects: orthostatic hypotension, cardiac toxicity, anticholinergic effects, screened w/ EKG
drug interactions w/ TCA
- TCA and MAOIs lead to severe hypertension
- TCA and CNS depressants
- no alc
TCA toxicity
dysrhythmias, tachycardia= primarily from cadiotoxic actions
treatment for TCA toxicity?
activated charcoal
when should TCA be taken?
at night to avoid sedation
MAOIs
- 2nd or 3rd choice for antidepressants
- TYRAMINE
prototype drug for MAOIs
Phenelzine
adverse effects of MAOIs
CNS Stim, orthostatic hypotension, hypertensive crisis
atypical antidep
Bupropion
doesn’t cause any of the side effects SSRI’s do
drug interactions of atypical
MAOIs can increase risk of bupropion toxicity
