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