Ch 20 Meds For Depressive Disorders Flashcards
Name TCA meds
Imipramine Doxepin Nortriptyline Amoxapine Trimipramine
What are uses for TCAs
Depressive disorders Neuropathic pain Fibromyalgia Anxiety disorders Insomnia
What are side effects of TCAS
Orthostatic hypotension Anticholinergic effects Sedation Decreased seizure threshold Diaphoresis
TCAs should be used cautiously in who
Ppl with coronary artery disease
Diabetes, liver, kidney, and respiratory disorders, urinary retention and obstruction, angle closure glaucoma
Benign prostatic hypertrophy and hyperthyroidism
What are med/ food interactions of TCAs
Concurrent use of MAOI can cause hypertensive crisis
The use of antihistamines can cause additive anticholinergic effects
Direct and indirect acting sympathomimetics
Alcohol, benzodiazepines, opioids,
Name SSRI DRUGS
Citalopram Escitalopram Paroxetine Sertraline Vilazodone
What are the therapeutic uses of SSRIs
Major depression
OCD, bulimia, premenstrual dysphoric disorders
Panic disorders
PTSD
WHAT ARE side effects of SSRIs
Sexual dysfunction CNS stimulation Wt loss followed by wt gain Serotonin syndrome Withdrawal syndrome, hyponatremia, Bruxism
What class of drugs treat depression
TCAs
SSRIs
MAOIs
Atypical antidepressants
What are med interactions of SSRIs
MAOI, TCA, St. John’s wort increase risk of serotonin syndrome
Coumadin levels will increase if taken concurrently
Lithium
NSAIDS anticoagulants can further suppress platelet aggregation
Name MAOIs
Isocarboxazid
Tranylcypromine
Selegiline ( transdermal patch
What are the therapeutic uses of MAOIs
Depression
Bulimia
What are side effects of MAOIs
CNS stimulation
Orthostatic hypotension
Hypertensive crisis from ingesting tyramine containing foods
Rash with transdermal patch
MAOIs are contraindicated in who
Ppl taking SSRIs or TCAs,those with pheochromocytoma, HF,cardiovascular and cerebral vascular disease and or severe renal insufficiency, diabetes or seizure disorder
What is selegiline and what are its contraindications
MAOI ( transdermal patch )
Contraindicated in ppl taking carbamazepine or oxcarbazepine because it will increase the levels of the MAOI
Name atypical antidepressants
Bupropion
What is the therapeutic intent of atypical antidepressants such as bupropion
Treats depression
Alternative to SSRIs
Aid to quit smoking
Prevention of seasonal pattern depression
What are side effects of atypical antidepressant
Headache, dry mouth, GI DISTRESS,constipation
Tachycardia, nausea, restlessness, wt loss, suppression of appetite
Seizures at higher dose ranges
Bupropion is contraindicated in who
Ppl with seizure disorder
Concurrent use of MAOIs
Anorexia or bulimia because bupropion suppresses the appetite
What are med interactions of the atypical antidepressant bupropion
Concurrent use of MAOIs may increase risk for toxicity discontinue MAOIs 2 weeks before beginning treatment of bupropion
Name other atypical antidepressant drugs
Venlafaxine Duloxetine Desvenlafaxine Mirtazapine Reboxetine Trazadone
What are nursing administrations for TCAs
Monitor for cardiac dysrhythmia said which are an indication of toxicity
Administer at bedtime because of sedation effects
What is nursing administration for SSRIs
Take in am to minimize sleep disturbances
Take with food to mimimize GI distress
Monitor sodium levels in older adults taking diuretics
For clients with seasonal pattern depression when should they begin taking bupropion
In the autumn and gradually taper dose and discontinue by spring
Priapism is a side effect of what drug
Trazadone which is a atypical antidepressant
What is nursing education for trazadone
Take at bedtime
