C8- Central Nervous System Medications Antidepressants Flashcards
Depression is a deficit of one or more of the biogenic amines:
Serotonin (5HT)
Norepinephrine (NE)
Dopamine (DA)
Diagnosis of depression needs 5 or more symptoms for 2 weeks or more, what are some of the symptoms?
-depressed mood most of the day
-loss of interest or pleasure in all or almost all activities
-significant weight loss/gain
-insomnia/hypersomnia
-fatigue
-worthlessness or guilt
-inability to thin or concentrate
-recurrent thoughts of death/suicide
-psychomotor agitation or retardation
Relief of depression may take how long?
4-6 weeks
When dosing of inpatients with antidepressants what should the nurse look for
cheeking
(preventing patient from accumulating multiple dose that might be taken with suicidal intent)
Prescriptions should be written how for antidepressants?
written for the smallest number of doses consistent with good patient management.
Who is most at risk for suicidal thoughts/tendencies while in early treatment?
children, adolescents and adults under 25
What is the prototype drug for tricyclic antidepressants?
Amitryptaline
Tricyclic antidepressant amitrptaline action
block neuronal reuptake of norepinephrine and serotonin
block acetylcholine and histamine receptors
therapeutic uses for tricyclic antidepressant amitryptaline
depression
bipolar disorder
neuropathic pain
fibromyalgia
chronic insomnia
adhd
panic disorder
OCD
Side effects of tricyclic antidepressant amitryptaline
sedation
orthostatic hypotension
anticholinergic effects (1-2 weeks)
cardio toxicity
photosensitivity
weight gain
diaphoresis
seizures (lowers seizure threshold)
hypomania
suicide risk
therapeutic effects of tricyclic antidepressants come into effect after?
4-6 weeks
Because TCA block receptors of histamine and acetylcholine, patients may experience side effects similar to
antihistamines
anticholinergics
Drug interactions of tricyclic antidepressants?
MAOIs (hypertensive crisis)
Anticholinergic agents (intensifies anticholinergic effects)
Sympathomimetics
CNS Depressants (alcohol)
Nursing administration of tricyclic antidepressants, when should you administer?
bedtime (h.s)
What should a nurse monitor for in regards to TCA administration?
suicidal precautions
warn of orthostatic hypotension
monitor cardiac function
monitor depression symptoms
Amitriptyline onset
physical 1-2 weeks
psychological 2-4 weeks
What is the T1/2 of amitriptyline?
10-26 hours
Avoid amitriptyline if pregnant due to what pregnancy category?
D- DO NOT USE
SSRIs stand for?
Selective serotonin reuptake inhibitors
There are two prototypes for SSRIs, what are they?
Fluoxetine
Citalopram
T or F, SSRIs are just as effective as TCAs
True
SSRIs do not cause:
hypotension
sedation
anticholinergic effects
cardiotoxicity
photosensitivity