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Pharmacology > Antidepressives > Flashcards

Antidepressives Flashcards

1
Q

What is the most important question to ask a pt c depression?

A

Do you have a any suicidal thoughts?

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2
Q

What s/s does one have to display & for how long?

A

5 must be present for minimum of 2 wk.

  1. Difficulty sleeping/sleeping too much
  2. Extremely tired/ w/o energy
  3. Vague physical symptoms
  4. Inability to concentrate/make decisions
  5. Feeling of despair, guilt, misery, lack self worth
  6. Obsessed c death
  7. Lack of interest in personal appearance/sex
  8. Delusions or hallucinations
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3
Q

RN Role for depression

A
  1. Obtain Hx
  2. R/O medical & neurological causes
  3. Ask about suicidal ideation
  4. Obtain family Hx
  5. Obtain v.s., liver/renal functions, Cardiovascular status, body wt.
  6. Monitor therapeutic blood levels
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4
Q

RN Education for depression

A
  1. Provide diet education about food that contain tyramine (MAOI)
  2. Provide info on s/s of dehydration
  3. Provide med education.
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5
Q

Anitdepressants general points

A
  1. Medical Dx- chemical imbalance or seratonin, dopamine, norepinephrine.
  2. Medication attempts to correct imbalance
  3. avoid alcohol
  4. Take 1-4 weeks for therapeutic effect
  5. DO NOT DC ABRUPTLY
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6
Q

RN Implication for depression

A
  1. Monitor v.s.
  2. Monitor neurologic & cardiovascular status
  3. Typically SNS response:
    Dizziness. headache, tremor, N/V, anxiety, disorientation, hyperflexia, daphoresis, fever.
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7
Q

Name 3 lines of antidepressants:

A
  1. Tricyclic
  2. SSRI
  3. MAOI
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8
Q

Tricyclic mechanism of action:

A
  1. Decrease reabsorption of norepinephrine & serotonin

2. Corrects imbalance in neurotransmitter concentration

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9
Q

Name 2 Tricyclic medications

A
  1. Elavil

2. Tofranil

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10
Q

What do Elavil and Tofranil Tx?

A
  1. Major depression
  2. Panic attacks
  3. OCD
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11
Q

Side effects of tricyclic’s

A
  1. Seizures
  2. OD
  3. Dry mouth
  4. Urinary retention
  5. Tremors
    Another words=SNS response
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12
Q

RN Implication & Teaching for TCA’s

A
  1. Take 2-4 weeks for therapeutic effect
  2. Avoid smoking
  3. Take @ bed time
  4. Orthostatic hypotension
  5. Suck on candy for dry mouth
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13
Q

In order, what are the safest antidepressants to use, 1 being safest 3 being most dangerous?

A
  1. SSRI
  2. MAOI
  3. Tricyclic
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14
Q

What are some contraindications for TCA’s?

A
  1. BPH
  2. Dysrhythmias
  3. Seizures
  4. Narrow-angle glaucoma
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15
Q

Name 1 SSRI medication

A
  1. Zoloft
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16
Q

What is SSRI mechanism of action?

A

Inhibits serotonin reuptake

17
Q

What do SSRI’s Tx?

A

Depression

18
Q

What are some Adverse Effects of SSRI?

A
  1. Agitation
  2. Jitters
  3. Anxiety
    SNS Response
  4. Decrease in REM sleep
19
Q

RN Implication & Teaching for SSRI

A
  1. DO NOT START W/I 2 WEEKS OF MAOI
  2. Monitor hepatic function
  3. Monitor seizure disorder
  4. Avoid alcohol, OTC meds, Herbs
  5. Take 1-4 weeks to achieve therapeutic effect
20
Q

Name 1 MAOI

21
Q

MAOI mechanism of action

A

Limit breakdown of norepinephrine, Dopamine & Serotonin

22
Q

What do MAOI Tx?

A

Depression

23
Q

What are some Adverse Effects of MAOI?

A
  1. Orthostatic hypotension
  2. Sexual dysfunction
  3. Wt gain
24
Q

RN Implication & Teaching for MAOI

A
  1. Keep CCB @ bedside as ANTIDOTE!
  2. Avoid foods high in tyramine & caffeine. Can lead to HTN crises.
  3. Mmonitor suicidal ideation
  4. Avoid alcohol
25
Name 4 classification of meds used for antianxiety. | 1 being the most used 4 being least used
1. Benzodiazepine 2. Barbiturates 3. Antidepressants 4. Nonbenzodiazepines/Nonbarbiturate CNS depressants
26
Name 2 Benzodiazepines used for anxiety
1. Ativan | 2. Valium
27
What are mechanism of action for benzodiazepines?
Changing action of GABA
28
What do benzodiazepines Tx?
1. Short-term seizures | 2. anxiety
29
RN Implication & Teaching for Benzodiazepine
1. Monitor respiration 2. Tolerance may develop 3. Assess for suicidal tendancy 4. DO NOT USE IN GLAUCOMA PT.
30
Antidote for Benzodiazepine
Romazicon
31
What are some contraindications for benzodiazepines?
1. Narrow-angle glaucoma 2. Acute alcohol intoxication 3. Children under 12 4. Renal & Hepatic dysfunction 5. Pregnancy & Lactation
32
What are some Adverse Effects for benzodiazepines?
PNS reaction 1. Drowsiness 2. Cardio irregularities 3. Constipation 4. Physical dependence

Pharmacology (19 decks)

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