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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

A
  1. Nardil
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
Q

Name 4 classification of meds used for antianxiety.

1 being the most used 4 being least used

A
  1. Benzodiazepine
  2. Barbiturates
  3. Antidepressants
  4. Nonbenzodiazepines/Nonbarbiturate CNS depressants
26
Q

Name 2 Benzodiazepines used for anxiety

A
  1. Ativan

2. Valium

27
Q

What are mechanism of action for benzodiazepines?

A

Changing action of GABA

28
Q

What do benzodiazepines Tx?

A
  1. Short-term seizures

2. anxiety

29
Q

RN Implication & Teaching for Benzodiazepine

A
  1. Monitor respiration
  2. Tolerance may develop
  3. Assess for suicidal tendancy
  4. DO NOT USE IN GLAUCOMA PT.
30
Q

Antidote for Benzodiazepine

A

Romazicon

31
Q

What are some contraindications for benzodiazepines?

A
  1. Narrow-angle glaucoma
  2. Acute alcohol intoxication
  3. Children under 12
  4. Renal & Hepatic dysfunction
  5. Pregnancy & Lactation
32
Q

What are some Adverse Effects for benzodiazepines?

A

PNS reaction

  1. Drowsiness
  2. Cardio irregularities
  3. Constipation
  4. Physical dependence

Pharmacology (19 decks)

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