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

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2
Q

recurrent disturbances or alterations in mood that cause psychological distress and
behavioral impairment

A

Mood Disorder

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3
Q

mood disorder that causes a
persistent feeling of sadness and loss of
interest

A

Depression

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4
Q

Major depression starts with an mood an emotion

T or F

A

T

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5
Q

Depression is a mood disorder becasue it persistant and cause a distrbance

T or F

A

T

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6
Q

Formally known as Dysthymia

Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder

A

Persistent Depressive Disorder

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7
Q

Which gender has more dpression?

A

Women

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8
Q

Which gender is more at risk for suicide

A

Men

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9
Q

Major Depressive Disorder

Must have ? of the following
symptoms for a ? period:

A

5 or more

two- week

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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

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11
Q

What is the mnemonic for Depression Symptoms

A

SIGECAPS

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12
Q

What does SIGECAPS mean

S1

A

Sleep Changes up and down

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13
Q

What does SIGECAPS mean

I

A

Interest down

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14
Q

What does SIGECAPS mean

G

A

Guilt up

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15
Q

What does SIGECAPS mean

E

A

Energy down

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16
Q

What does SIGECAPS mean

C

A

Concentration Down

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17
Q

What does SIGECAPS mean

A

A

Appetite Changes up and down

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18
Q

What does SIGECAPS mean

P

A

Psychomotor agitation or retardation up and down (move fast or slow)

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19
Q

What does SIGECAPS mean

S2

A

Suicide Ideation up

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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

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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

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22
Q

Diagnosis: Depressed mood + TWO
other symptoms

Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder

A

Persistent Depressive Disorder

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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

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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

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25
Q

Children have Severe, chronic irritability with angry mood

Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder

A

Disruptive Mood Dysregulation disorder

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26
Q

Disruptive Mood Dysregulation disorder

Frequent temper outbursts at least ? times/week

A

three

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27
Q

Verbal rages, aggression or both: people and/or property

Persistent Depressive Disorder
Major Depressive Disorder
Disruptive Mood Dysregulation disorder

A

Disruptive Mood Dysregulation disorder

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28
Q

Disruptive Mood Dysregulation disorder

Applies to children ? yo; Onset before ? years of age

A

6-18

10

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29
Q

What are the three neurotransmitters associated with Depression?

A

Norepinephrine (NE)
Serotonin (5-HT)
Dopamine (DA

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30
Q

Etiology of Depression: Genetics 3

A

Hereditary
Twins
Environmental Factors

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31
Q

Etiology of Depression: Endocrine 4 abnormalities Look up this

A

hypothalamic-pituitary-adrenal axis
(HPA axis)
Cortisol
Thyroid
Hormonal

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32
Q

Etiology of Depression:

Which of the following affects depression?

Circadian Rhythm
Brain Anatomy
None
Both

A

Both

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33
Q

Etiology of Depression:

sleep disturbances (disrupted
? caused by depression or did depression
cause disrupt ?

A

Circadian Rhythm both

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34
Q

Etiology of Depression:

? decreased volumes)
in the ? and ?.

A

Brain atrophy

prefrontal cortex
hippocampus

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35
Q

Psychosocial Theories

Leads to depression and mood disorders

Intrapsychic Conflict
Unfavorable early life experiences
Reaction to stress

A

Unfavorable early life experiences

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36
Q

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

A

Intrapsychic Conflict

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37
Q

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

A

Reaction to stress

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38
Q

Loss of interest or pleasure

A

Anhedonia

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39
Q

Which Nursing Assessment for Depressive
Disorders what is prioty

A

Safety

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40
Q

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

A
  • SAFETY!
  • Assess presence of suicidal ideation
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41
Q

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

A

*History and Physical
*Substance andMedication Use
*Behaviors impacted by MDD:
*Nutrition, sleep, energy etc

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42
Q

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

A

*Mood and affect
* *Thought content
* *Cognition and memory
* Social Support
* Stress and Coping
* *Components of MSE
*Maladaptive
*Adaptive

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43
Q

An actions that can prevent a person from adapting to life, and can be harmful to their physical and mental health

A

Maladaptive

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44
Q

Is a collection of skills that people learn to function in their daily lives

A

Adaptive

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45
Q

? and medication is needed to in better pt mental health

A

CBT Theraphy

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46
Q

Depression Nursing Intervention

Pharmacotherapy
3

A

Monitoring efficacy
side effects and interactions
Patient Education

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47
Q

Depression Nursing Intervention
Electroconvulsive Therapy (ECT)

Electric current is passed through the brain causing a ? ( ? to ? secs)

A

seizure, 30, 90

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48
Q

Depression Nursing Intervention
Electroconvulsive Therapy (ECT)

ECT administered ? week until remission or up to ? treatments

A

2-3X
12

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49
Q

Depression Nursing Intervention
Electroconvulsive Therapy (ECT)

Causes ?
Pt may need ?

A

Headaches
Oxygen

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50
Q

Depression Nursing Intervention
Electroconvulsive Therapy (ECT)

Nursing responsibilities ventilate the patient , monitor ? , help with reorientation to a ?

A

vital signs
person, place, time

51
Q

Depression Nursing Intervention
Electroconvulsive Therapy (ECT)

? PRN for ?

A

Benzodiazepine

agitation

52
Q

medical condition that causes a person to be unable to relax and remain still

A

Psychomotor Agitation

53
Q

medical condition that involves a slowing down of physical and mental activities

A

Psychomotor Retardation

54
Q

Treatment for Seasonal affective disorder

A

Bright Light Therapy (formally for phototherapy)

55
Q

Bright Light Therapy (formally for phototherapy) Adverse side effect?

2

A

Nausea
Eye irritation

56
Q

Bright Light Therapy (formally for phototherapy) Contraindications

A

Glaucoma
Cataracts
Photosynthesizing medications

57
Q

Classifications of Antidepressants
5

A

*SSRl
*SNRl
*NDRl
*MAOl
*TCA

58
Q

Most Antidepressants medications take ? weeks to have an effect; never meant as ?

A

2-8
PRN

59
Q

Do stop Antidepressants medications ?

A

abruptly

60
Q

When a pt experiences fever, chills, headaches, nasea, swaeting, etc when they abruptly stop Antidepressants medications?

A

Discontinuation Syndrome

61
Q

(life-threatening condition!) from overactivity of serotonin or an impairment of the serotonin metabolism

A

Serotonin syndrome

62
Q

? patients with depression experience only partial (or no) relief with current medication regimen.

A

1 in 3

63
Q

? need washout periods between starting new class

A
  • Some medications (MAOIs!)
64
Q

Whats the wash out period for MAOIs

A

2 weeks

65
Q

High risk of inducing mania in patients with bipolar disorder with what medication?

A

SSRI, SNRI

66
Q

? is a concern with most antidepressants (Even MAOIs)

A

Orthostatic hypotension

67
Q

All antidepressants have a black box warning: Increased risk of suicidal thoughts and behaviors in patients aged ?

A

24 and younger.

68
Q

SSRI

A

Selective Serotonin Reuptake
Inhibitors

69
Q

MOA: inhibition of reuptake of
serotonin

A

SSRI

70
Q

? is only SSRI approved for children > 8 years old

Paroxetine
Fluoxetine
Citalopram
Escitalopram
Sertraline
Fluvoxamine
Volazodone
Vortioxetine

A

Fluoxetine

71
Q

? is only SSRI approved for children > 8 years old

(Paxil)
(Prozac)
(Celexa)
(Lexapro)
(Zoloft)
(Luvox)
(Viibryd)
(Trintellix)

A

(Prozac)

72
Q

? is only SSRI approved for children > ? years old

A

Fluoxetine
8

73
Q

a condition where a person grinds, clenches, or gnashes his or her teeth

A

bruxism

74
Q

What causes bruxism

A

SSRI, SNRI, TCA, MAOI

75
Q

SSRI, SNRI, TCA, MAOI Mnemonics 7 S’s

S
S
S
S
S
S
S

A

Sexual dysfunction
Stomach Upset
Size increase (weight)
Sleep difficulties
Suicidal Ideation
Serotonin Syndrome
Sodium loss

76
Q

Sodium Loss/Hyponatremia,
can be seen in geriatrics!

A

SSRI, SNRI, TCA, MAOI

77
Q

Has Platelets risk that can increase bleeding

A

SSRI, SNRI, TCA, MAOI

78
Q

Careful with NSAIDS, anticoagulants

A

SSRI, SNRI, TCA, MAOI

79
Q

Mania risk

A

SSRI, SNRI, TCA, MAOI

80
Q

Educate patients to take in the morning to avoid insomnia

A

SSRI, SNRI, MAOI

81
Q

Monitor for history of GI Bleeds

A

SSRI, SNRI, TCA, MAOI

82
Q

Patients should be educated to report any sexual functions problems to
their provider

A

SSRI, SNRI, TCA, MAOI

83
Q

MOA: prevention of reuptake of norepinephrine and serotonin

A

SNRI

84
Q

Monitor for hypertension

A

SNRI

85
Q

They can still have postural hypotension like the other antideprssant drugs even though it causes hypertension

A

SNRI

86
Q

MOA: inhibition of norepinephrine and
dopamine reuptake; antagonist at nicotinic
receptor

A

NDRI

87
Q

agitation or anxiety and insomnia

A

NDRI

88
Q

appetite suppression
weight loss

A

NDRI

89
Q

Psychosis is a mental condition that causes a person to have difficulty distinguishing reality from fantasy

A

NDRI

90
Q

headache

A

NDRI

91
Q

dry mouth
GI distress (constipation, nausea)

A

NDRI

92
Q

increased heart rate

A

NDRI

93
Q

seizure risk

A

NDRI, TCA

94
Q

Less sedating than SSRI/SNRIs

A

NDRI

95
Q

NDRI Treats: 4

A

Smoking cessation,, weight loss, sexual dysfunction, ADHD

96
Q

Treats insomnia

A

TCA

97
Q

Treats neuropathic pain

A

TCAs

98
Q

Reduce reuptake of norepinephrine and
serotonin. Also potential to block
cholinergic, histaminergic, and α1 receptors

A

TCA

99
Q

A higher lethal potential of CARDIAC TOXICITY EKG baseline

A

TCA

100
Q

Anticholinergic (delirium, seizures)

A

TCA

101
Q

Watch out for the heart, also alpha-1 blockade- orthostatic hypotension/dizziness

A

TCA

102
Q

Inhibits MAO enzymes

A

MAOI

103
Q

Wash out period: There must be a 2-week (14 day) wash out!

A

MAOI

104
Q

This washout period is BOTH directions

A

MAOI

105
Q

Patients should be closely monitored and educated about hypertensive crisis

A

MAOI

106
Q

Which can cause an hypertensive crisis

A

MAOI

107
Q

What should you avoid with MAOI to prevent hypertensive crisis

A

Anything high in Tyramine

108
Q

Tyramine mnemonic

A

Aged, Fermented, Overripe, and Cured

109
Q

Which deals with Serotonin Syndrome

A

SSRI, SNRI, MAOI

110
Q

Serotonin Syndrome

Onset - ? hours after medication is started

A

2-72

111
Q

Serotonin Syndrome

Treatment?

A

Stop the mediation

112
Q

Serotonin Syndrome mnemonic

A

SHIVERS

113
Q

Serotonin Syndrome mnemonic
SHIVERS

S

A

Shivering

114
Q

Serotonin Syndrome mnemonic
SHIVERS

H

A

Hyperreflexia (ataxia/tremors)

115
Q

neurological sign that causes a lack of muscle coordination and balance

A

ataxia

116
Q

Serotonin Syndrome mnemonic
SHIVERS

I

A

Increased Temperature:

117
Q

Serotonin Syndrome mnemonic
SHIVERS

V

A

Vital Sign Abnormalities
Tachycardia, tachypnea, and labile blood
pressure

118
Q

Serotonin Syndrome mnemonic
SHIVERS

E

A

Encephalopathy (alter mental status agitation)

119
Q

Serotonin Syndrome mnemonic
SHIVERS

R

A

Restlessness (can nor relax)

120
Q

Serotonin Syndrome mnemonic
SHIVERS

S

A

Sweating

121
Q

With Serotonin Syndrome what do you do

A

Stop medicatio
Cool pt + Hydrate
Atihistimine drug (cyproheptadine)
Monitor Vitals

122
Q

Depression Screening Instruments:

Instrument to aid in the “screening,
diagnosing, monitoring and measuring” of
depression severity

A

PHQ-9

123
Q

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?

A

PHQ-2

124
Q

SHORT DEPRESSION SCREENING

A

PHQ-2