Atypical Anti Depressant/Anti Anxiety

Question 1

bupropion: class

Answer 1

• antidepressant
• smoking deterrent

Question 2

buproprion: MOA

Answer 2

• stimulant
• blockade of dopamine/NE reuptake

Question 3

bupropion: indications

Answer 3

• major depressive disorder
• prevention of seasonal affective disorder
• smoking cessation
• unlabeled use: relief of neuropathic pain, tx of depressive disorders in bipolar, mgmt of ADHD

Question 4

bupropion: SEs

Answer 4

• agitation
• headache
• dry mouth
• constipation
• weight loss
• photosensitivity
• tremor
• insomnia
• blurred vision
• inc sexual desire
• psychotic symptoms: hallucinations, delusions

Question 5

bupropion: ADRs

Answer 5

• suicide risk in children, adolescents, young adults
• seizures

Question 6

bupropion: nursing implications

Answer 6

• contraindicated: seizure disorders, breast feeding
• exercise extreme caution in children b/c of inc risk of suicide
• to reduce risk of seizures:
  
  • avoid doses above 450 mg/day
  • avoid in pts with other seizure risk factors
• avoid bedtime doses b/c can cause insomnia
• for SAD: Begin administration in autumn prior to the onset of depressive symptoms. Continue therapy through winter and begin to taper and discontinue in early spring.
• may need to take for at least 4 weeks to see effects
• Inform patient that frequent mouth rinses, good oral hygiene, and sugarless gum or candy may minimize dry mouth.
• use sunscreen and protective clothing to prevent photosensitivity reactions.

Question 7

buspirone: class

Answer 7

• anxiolytic drug
• anti-anxiety

Question 8

buspirone: MOA

Answer 8

• NOT a CNS depressant
• binds with high affinity to receptors for serotonin and with lower affinity to receptors for dopamine

Question 9

buspirone: indication

Answer 9

• generalized anxiety disorder

Question 10

buspirone: SEs

Answer 10

• dizziness
• nausea
• headache
• nervousness
• sedation
• lightheadedness
• excitement
• fatigue
• blurred vision
• tachycardia
• angina
• rashes
• myalgia
• numbness
• paresthesia
• clamminess

Question 11

buspirone: nursing implications

Answer 11

• contraindicated: hepatic/renal impairment
• no withdrawal symptoms noticed
• do not consume grapefruit juice
• no abuse potential and does not intensify the effectsof CNS depressants (benzos, alcohol, barbiturates)
• effects take weeks to appear
  
  • so NOT suitable for PRN use
• can take with food