Depressive Disorders and Antidepressants Flashcards
1
Q
pervasive and sustained
emotion that colors one’s perception
of the world and how one functions in
A
Mood
2
Q
recurrent disturbances or alterations in mood that cause psychological distress and
behavioral impairment
A
Mood Disorder
3
Q
mood disorder that causes a
persistent feeling of sadness and loss of
interest
A
Depression
4
Q
Major depression starts with an mood an emotion
T or F
A
T
5
Q
Depression is a mood disorder becasue it persistant and cause a distrbance
T or F
A
T
6
Q
Formally known as Dysthymia
Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder
A
Persistent Depressive Disorder
7
Q
Which gender has more dpression?
A
Women
8
Q
Which gender is more at risk for suicide
A
Men
9
Q
Major Depressive Disorder
Must have ? of the following
symptoms for a ? period:
A
5 or more
two- week
10
Q
Major Depressive Disorder has which of the following symptoms
a. Hypotension
b. Depressed mood
c. High Blood Sugar
d. Diminished interest/pleasure in activities
A
b. Depressed mood
d. Diminished interest/pleasure in activities
11
Q
What is the mnemonic for Depression Symptoms
A
SIGECAPS
12
Q
What does SIGECAPS mean
S1
A
Sleep Changes up and down
13
Q
What does SIGECAPS mean
I
A
Interest down
14
Q
What does SIGECAPS mean
G
A
Guilt up
15
Q
What does SIGECAPS mean
E
A
Energy down
16
Q
What does SIGECAPS mean
C
A
Concentration Down
17
Q
What does SIGECAPS mean
A
A
Appetite Changes up and down
18
Q
What does SIGECAPS mean
P
A
Psychomotor agitation or retardation up and down (move fast or slow)
19
Q
What does SIGECAPS mean
S2
A
Suicide Ideation up
20
Q
Persistent Depressive Disorder
Depressed mood for most of the day,
for more days than not, as indicated by
either subjective account or
observation by others, for at least ? for adults
A
2 years
21
Q
Persistent Depressive Disorder
epressed mood for most of the day,
for more days than not, as indicated by
either subjective account or
observation by others, for at least ? in children or adolescent
A
1 year
22
Q
Diagnosis: Depressed mood + TWO
other symptoms
Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder
A
Persistent Depressive Disorder
23
Q
Must have 5 or more of the following
symptoms for a two- week period
Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder
A
Major Depressive Disorder
24
Q
Differentiates children with severe irritability versus bipolar disorder (children are normally diagnosis with BD)
Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder
A
Disruptive Mood Dysregulation disorder
25
Children have Severe, chronic irritability with angry mood
Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder
Disruptive Mood Dysregulation disorder
26
Disruptive Mood Dysregulation disorder
Frequent temper outbursts at least ? times/week
three
27
Verbal rages, aggression or both: people and/or property
Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder
Disruptive Mood Dysregulation disorder
28
Disruptive Mood Dysregulation disorder
Applies to children ? yo; Onset before ? years of age
6-18
10
29
What are the three neurotransmitters associated with Depression?
Norepinephrine (NE)
Serotonin (5-HT)
Dopamine (DA
30
Etiology of Depression: Genetics 3
Hereditary
Twins
Environmental Factors
31
Etiology of Depression: Endocrine 4 abnormalities Look up this
hypothalamic-pituitary-adrenal axis
(HPA axis)
Cortisol
Thyroid
Hormonal
32
Etiology of Depression:
Which of the following affects depression?
Circadian Rhythm
Brain Anatomy
None
Both
Both
33
Etiology of Depression:
sleep disturbances (disrupted
? caused by depression or did depression
cause disrupt ?
Circadian Rhythm both
34
Etiology of Depression:
? decreased volumes)
in the ? and ?.
Brain atrophy
prefrontal cortex
hippocampus
35
Psychosocial Theories
Leads to depression and mood disorders
Intrapsychic Conflict
Unfavorable early life experiences
Reaction to stress
Unfavorable early life experiences
36
Psychosocial Theories
Mixed emotions about a behavior, event, or situation. If unresolved it can lead to depression
Intrapsychic Conflict
Unfavorable early life experiences
Reaction to stress
Intrapsychic Conflict
37
Psychosocial Theories
Prolonged grief (when normal becomes abnormal) of: role transition, social isolation, economic hardship, other major stressors
Intrapsychic Conflict
Unfavorable early life experiences
Reaction to stress
Reaction to stress
38
Loss of interest or pleasure
Anhedonia
39
Which Nursing Assessment for Depressive
Disorders what is prioty
Safety
40
Nursing Assessment for Depressive
Disorders: Primary
*History and Physical
*Substance andMedication Use
*Behaviors impacted by MDD:
*Nutrition, sleep, energy etc
*Mood and affect
* *Thought content
* *Cognition and memory
* Social Support
* Stress and Coping
* *Components of MSE
* SAFETY!
* Assess presence of suicidal ideation
* SAFETY!
* Assess presence of suicidal ideation
41
Nursing Assessment for Depressive
Disorders: Biological
*History and Physical
*Substance andMedication Use
*Behaviors impacted by MDD:
*Nutrition, sleep, energy etc
*Mood and affect
* *Thought content
* *Cognition and memory
* Social Support
* Stress and Coping
* *Components of MSE
* SAFETY!
* Assess presence of suicidal ideation
*History and Physical
*Substance andMedication Use
*Behaviors impacted by MDD:
*Nutrition, sleep, energy etc
42
Nursing Assessment for Depressive
Disorders: Psychosocial
*History and Physical
*Substance andMedication Use
*Behaviors impacted by MDD:
*Nutrition, sleep, energy etc
*Mood and affect
* *Thought content
* *Cognition and memory
* Social Support
* Stress and Coping
* Components of MSE
* SAFETY!
* Assess presence of suicidal ideation
*Maladaptive
*Adaptive
*Mood and affect
* *Thought content
* *Cognition and memory
* Social Support
* Stress and Coping
* *Components of MSE
*Maladaptive
*Adaptive
43
An actions that can prevent a person from adapting to life, and can be harmful to their physical and mental health
Maladaptive
44
Is a collection of skills that people learn to function in their daily lives
Adaptive
45
? and medication is needed to in better pt mental health
CBT Theraphy
46
Depression Nursing Intervention
Pharmacotherapy
3
Monitoring efficacy
side effects and interactions
Patient Education
47
Depression Nursing Intervention
Electroconvulsive Therapy (ECT)
Electric current is passed through the brain causing a ? ( ? to ? secs)
seizure, 30, 90
48
Depression Nursing Intervention
Electroconvulsive Therapy (ECT)
ECT administered ? week until remission or up to ? treatments
2-3X
12
49
Depression Nursing Intervention
Electroconvulsive Therapy (ECT)
Causes ?
Pt may need ?
Headaches
Oxygen
50
Depression Nursing Intervention
Electroconvulsive Therapy (ECT)
Nursing responsibilities ventilate the patient , monitor ? , help with reorientation to a ?
vital signs
person, place, time
51
Depression Nursing Intervention
Electroconvulsive Therapy (ECT)
? PRN for ?
Benzodiazepine
agitation
52
medical condition that causes a person to be unable to relax and remain still
Psychomotor Agitation
53
medical condition that involves a slowing down of physical and mental activities
Psychomotor Retardation
54
Treatment for Seasonal affective disorder
Bright Light Therapy (formally for phototherapy)
55
Bright Light Therapy (formally for phototherapy) Adverse side effect?
2
Nausea
Eye irritation
56
Bright Light Therapy (formally for phototherapy) Contraindications
Glaucoma
Cataracts
Photosynthesizing medications
57
Classifications of Antidepressants
5
*SSRl
*SNRl
*NDRl
*MAOl
*TCA
58
Most Antidepressants medications take ? weeks to have an effect; never meant as ?
2-8
PRN
59
Do stop Antidepressants medications ?
abruptly
60
When a pt experiences fever, chills, headaches, nasea, swaeting, etc when they abruptly stop Antidepressants medications?
Discontinuation Syndrome
61
(life-threatening condition!) from overactivity of serotonin or an impairment of the serotonin metabolism
Serotonin syndrome
62
? patients with depression experience only partial (or no) relief with current medication regimen.
1 in 3
63
? need washout periods between starting new class
* Some medications (MAOIs!)
64
Whats the wash out period for MAOIs
2 weeks
65
High risk of inducing mania in patients with bipolar disorder with what medication?
SSRI, SNRI
66
? is a concern with most antidepressants (Even MAOIs)
Orthostatic hypotension
67
All antidepressants have a black box warning: Increased risk of suicidal thoughts and behaviors in patients aged ?
24 and younger.
68
SSRI
Selective Serotonin Reuptake
Inhibitors
69
MOA: inhibition of reuptake of
serotonin
SSRI
70
? is only SSRI approved for children > 8 years old
Paroxetine
Fluoxetine
Citalopram
Escitalopram
Sertraline
Fluvoxamine
Volazodone
Vortioxetine
Fluoxetine
71
? is only SSRI approved for children > 8 years old
(Paxil)
(Prozac)
(Celexa)
(Lexapro)
(Zoloft)
(Luvox)
(Viibryd)
(Trintellix)
(Prozac)
72
? is only SSRI approved for children > ? years old
Fluoxetine
8
73
a condition where a person grinds, clenches, or gnashes his or her teeth
bruxism
74
What causes bruxism
SSRI, SNRI, TCA, MAOI
75
SSRI, SNRI, TCA, MAOI Mnemonics 7 S's
S
S
S
S
S
S
S
Sexual dysfunction
Stomach Upset
Size increase (weight)
Sleep difficulties
Suicidal Ideation
Serotonin Syndrome
Sodium loss
76
Sodium Loss/Hyponatremia,
can be seen in geriatrics!
SSRI, SNRI, TCA, MAOI
77
Has Platelets risk that can increase bleeding
SSRI, SNRI, TCA, MAOI
78
Careful with NSAIDS, anticoagulants
SSRI, SNRI, TCA, MAOI
79
Mania risk
SSRI, SNRI, TCA, MAOI
80
Educate patients to take in the morning to avoid insomnia
SSRI, SNRI, MAOI
81
Monitor for history of GI Bleeds
SSRI, SNRI, TCA, MAOI
82
Patients should be educated to report any sexual functions problems to
their provider
SSRI, SNRI, TCA, MAOI
83
MOA: prevention of reuptake of norepinephrine and serotonin
SNRI
84
Monitor for hypertension
SNRI
85
They can still have postural hypotension like the other antideprssant drugs even though it causes hypertension
SNRI
86
MOA: inhibition of norepinephrine and
dopamine reuptake; antagonist at nicotinic
receptor
NDRI
87
agitation or anxiety and insomnia
NDRI
88
appetite suppression
weight loss
NDRI
89
Psychosis is a mental condition that causes a person to have difficulty distinguishing reality from fantasy
NDRI
90
headache
NDRI
91
dry mouth
GI distress (constipation, nausea)
NDRI
92
increased heart rate
NDRI
93
seizure risk
NDRI, TCA
94
Less sedating than SSRI/SNRIs
NDRI
95
NDRI Treats: 4
Smoking cessation,, weight loss, sexual dysfunction, ADHD
96
Treats insomnia
TCA
97
Treats neuropathic pain
TCAs
98
Reduce reuptake of norepinephrine and
serotonin. Also potential to block
cholinergic, histaminergic, and α1 receptors
TCA
99
A higher lethal potential of CARDIAC TOXICITY EKG baseline
TCA
100
Anticholinergic (delirium, seizures)
TCA
101
Watch out for the heart, also alpha-1 blockade- orthostatic hypotension/dizziness
TCA
102
Inhibits MAO enzymes
MAOI
103
Wash out period: There must be a 2-week (14 day) wash out!
MAOI
104
This washout period is BOTH directions
MAOI
105
Patients should be closely monitored and educated about hypertensive crisis
MAOI
106
Which can cause an hypertensive crisis
MAOI
107
What should you avoid with MAOI to prevent hypertensive crisis
Anything high in Tyramine
108
Tyramine mnemonic
Aged, Fermented, Overripe, and Cured
109
Which deals with Serotonin Syndrome
SSRI, SNRI, MAOI
110
Serotonin Syndrome
Onset - ? hours after medication is started
2-72
111
Serotonin Syndrome
Treatment?
Stop the mediation
112
Serotonin Syndrome mnemonic
SHIVERS
113
Serotonin Syndrome mnemonic
SHIVERS
S
Shivering
114
Serotonin Syndrome mnemonic
SHIVERS
H
Hyperreflexia (ataxia/tremors)
115
neurological sign that causes a lack of muscle coordination and balance
ataxia
116
Serotonin Syndrome mnemonic
SHIVERS
I
Increased Temperature:
117
Serotonin Syndrome mnemonic
SHIVERS
V
Vital Sign Abnormalities
Tachycardia, tachypnea, and labile blood
pressure
118
Serotonin Syndrome mnemonic
SHIVERS
E
Encephalopathy (alter mental status agitation)
119
Serotonin Syndrome mnemonic
SHIVERS
R
Restlessness (can nor relax)
120
Serotonin Syndrome mnemonic
SHIVERS
S
Sweating
121
With Serotonin Syndrome what do you do
Stop medicatio
Cool pt + Hydrate
Atihistimine drug (cyproheptadine)
Monitor Vitals
122
Depression Screening Instruments:
Instrument to aid in the “screening,
diagnosing, monitoring and measuring” of
depression severity
PHQ-9
123
Depression Screening Instruments:
1) Over the past two weeks, have you felt
down, depressed, or hopeless?
2) Over the past two weeks, have you felt
little interest or pleasure in doing what
you usually do?
PHQ-2
124
SHORT DEPRESSION SCREENING
PHQ-2
