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Pharmacology > Antidepressants, Anxiety and Insomnia > Flashcards

Antidepressants, Anxiety and Insomnia Flashcards

1
Q

S&S antidepressant discontinuation syndrome

A

Flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal

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2
Q

Side effects/adverse reactions of tricyclic antidepressants

A

Anticholinergic
Drowsiness and dizziness
Weight gain
Suicidal ideation
orthostatic hypotension
Histamine effects: sleepiness

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3
Q

Interactions of Tricyclic antidepressants, SSRIs

A

Alcohol and other CNS depressants
MAOIs: > serotonin and norepinephrine
Grapefruit

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4
Q

MOAI
Prototype
Action
use

A

Phenelzine
Prevents destroying epinephrine, dopamine, epinephrine and serotonin
Depression not controlled

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5
Q

Phenelzine interactions

A

CNS stimulants
Vasoconstrictors and cold medications
Other antidepressants
Tyramine-hypertension

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6
Q

Antidepressant general characteristics

A

2-4 weeks before depressive symptoms improve
Metabolized in liver
Taper antidepressants

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7
Q

Tricyclic antidepressants
Prototype
Action
Use

A

Imipramine
Blocks histamine receptors. Blocks cholinergic receptors. Inhibit reuptake of norepinephrine and serotonin
Use: major depression

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8
Q

Why must you avoid grapefruits when taking antidepressants

A

Inhibits specific enzymes in the liver which causes the body to not be able to metabolize the drug–>drug toxicity

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9
Q

SSRIs
Prototype
Action
Use

A

Fluoxetine (prozac),
Action: block reuptake of serotonin
Uses: major depression, anxiety disorders, prevention of migraine headaches
Venlafaxine
Action: inhibit reuptake of serotonin and norepinephrine
Use: major depression, GAD

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10
Q

Side effects/Adverse reactions of Fluoxetine

A

GI distress (N/V/D)
Urinary retention, sexual dysfunction
Suicidal ideation
Serotonin syndrome

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11
Q

Symptoms of serotonin syndrome

A

Hypertensive crisis, fever, agitation, rigidity

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12
Q

Side effects of venlafaxine

A

Drowsiness, dizziness, GI distress, urinary retention, sexual dysfunction, suicidal ideation

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13
Q

Phenelzine side effects

A

Agitation, restlessness, insomnia
Orthostatic hypotension

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14
Q

Atypical antidepressants
Prototype
Action
use

A

Bupropion
Action: Affect 1, 2, or all neurotransmitters: serotonin, norepinephrine, and dopamine
Use: MDD, Reactive depression, anxiety

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15
Q

Atypical antidepressants
Interaction

A

Do not take with MAOIs/ do not use within 14 days of discontinuing MAOIs

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16
Q

Nursing interventions atypical antidpressants

A

Monitor vital signs
Monitor for drug-drug and food-drug interactions
Provide pt with a list of foods to avoid

17
Q

Signs of depression

A

Mood changes, insomnia, apathy, lack of interest in activities

18
Q

Mood stabilizer
Prototype
Action
Use

A

Lithium carbonate
Action: Stabilizes receptor activity
Use: Bipolar disorder manic episodes. Keeps mood balanced

19
Q

Side effects/Adverse reactions of mood stabilizer

A

Metallic taste
Hand tremors, weakness
Polyuria, polydipsia (excess thirst)
edema, weight gain
Lithium is a salt so you urinate more to try to balance electrolytes

20
Q

Mood stabilizer interactions

A

Increased lithium levels with thiazides
Decrease: caffeine, loop diuretics

21
Q

What do you do if a medication has a narrow therapeutic range

A

Come in often to check for labs and maybe edit the dose

22
Q

Benzodiazepines
Prototype
Action
Use vs major use

A

Diazepam
Action: Enhances GABA to reduce neuron excitability (> GABA=drowsiness & daytime sleepiness)
Use: reduce anxiety, treat insomnia
Major use: Anticonvulsant
Preoperative sedation, prevention of agitation and DTs (delirium tremens) in acute alcohol withdrawal

23
Q

Nursing interventions and education of benzos

A

Nursing interventions: Nonpharmacologic methods
Tapered: if not experience withdrawal symptoms

24
Q

Nonbenzodiazepines
Prototype
Uses

A

Zolpidem (Ambien)
Used as a sleep aid, same effect as benzodiazepines, but structurally different

25
Q

Can benzos/nonbenzos be used as a sleep aid?

A

Still be groggy, not totally metabolized yet
Cause weird dreams

26
Q

drug therapy side effects for benzos

A

CNS depressant: dizziness, drowsiness, uncoordinated, confusion, poor concentration

Pharmacology (10 decks)

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