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MENTALHEALTH > Depressive Disorders CH. 14 > Flashcards

Depressive Disorders CH. 14 Flashcards

1
Q

Selective serotonin reputable inhibitors SSRIs

A

Citalopram- Celexa

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2
Q

Selective serotonin reputable inhibitors SSRIs

A

Fluoxetine- Prozac

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3
Q

Selective serotonin reputable inhibitors SSRIs

A

Sertraline- Zoloft

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4
Q

Selective serotonin reputable inhibitors SSRIs

A

Education:
Advise on AE: Nausea, headache, CNS stimulation (agitation, insomnia, anxiety) rash
Sexual dysfunction can occur & notify HCP if effects are intolerable
Observe for manifestations of serotonin syndrome. If occur withhold medication and notify HCP
Avoid the concurrent use of St.John’s Wort it ⬆️ r/o serotonin syndrome
Follow a healthy diet, exercise regimen due to wt. gain can occur w/long term use

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5
Q

Tricyclic antidepressants

A

Amitriptyline- Elavil

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6
Q

Tricyclic antidepressants

A

Education:
Advise client to change positions slowly to minimize dizziness from Ortho.Hypotension, tachycardia
Minimize anticholinergic effects such as chew sugarless gum, eat foods w/ high fiber, ⬆️ fluid intake 2-3L/day from food & beverages

Constipation / urinary is emergent

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7
Q

Monoamine oxidase inhibitors MAOI

A

Phenelzine- Nardil

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8
Q

Monoamine oxidase inhibitors MAOI

A

Instruct the client to avoid all medications, including OTC w/o first discussing then w/ HCP due to r/o medication interactions

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9
Q

Atypical antidepressants

A

Bupropion- Wellbutrin
High dose increases seizures risk for insomnia, N&V, headache

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10
Q

Atypical antidepressants

A

Education:
Advise client to observe for headache, dry mouth, GI distress, constipation,⬆️ HR, nausea, restlessness,insomnia and notify HCP if they become intolerable

Monitor the client food intake & weight due to appetite suppression

Avoid administering to clients at risk for seizures

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11
Q

Serotonin norepinephrine reuptake inhibitors

A

Venlafaxine- Effexor XR

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12
Q

Serotonin norepinephrine reuptake inhibitors

A

Duloxetine- Cymbalta

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13
Q

Serotonin norepinephrine reuptake inhibitors

A

Education:
AE nausea, insomnia, wt.gain, diaphoresis, and sexual dysfunction

Caution ⚠️ in administrating to clients who have hx of HTN

SE: HTN, Tachycardia, Adrenergic effects, same as SSRIs

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14
Q

Alternative or Complementary therapies

A

ST. John’s wort: plant product (hypericum perforatum) not regulated by the US food and drug administration, is taken by some individuals to relieve manifestations of mild depression
Vivid dreams
AE: photosensitivity, skin rash, rapid HR, gastrointestinal distress, Abd.Pain

Can increase or reduce levels of some medications 💊 if take concurrently. The client should inform the HCP if taking St. John’s wart

‼️Med.Interactions: Potentially fatal ☠️ serotonin syndrome can result w/ St. John’s wart if taken w/ SSRIs or other types of antidepressants. Foods containing tyramine should be avoided ‼️

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15
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

Escitalopram- Lexapro

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16
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

Paroxetine- Paxil

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17
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

Fluvoxamine-Luvox

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18
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

Vilazodone-Viibyrd

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19
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

Vortioxetine-Briitellix

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20
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

MOA: all block the reuptake and the degradation (breaking down) of serotonin 5 HT

Psycho therapy for TX

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21
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

7 S’s
-stomach upset mild nausea and bowel movements
-sexual dysfunction- anorgasmia delay, absence of organism
-sleep difficulties
-stress- aggravation, anxiety & tremors
-size increase- wt gain
-suicidal thoughts- 24yrs and ⬇️
-serotonin syndrome- fatal syndrome of having to much serotonin overstimulation. Rapid onset diarrhea,seizures, hyperthermia, muscle ridgity,coma ,death

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22
Q

Selective Serotonin Reuptake Inhibitors- SSRIs

A

1st line therapy for most types of depression
Low side effect profile compared w/older antidepressants.
Effective in depression/anxiety features as well as depression w/psychomotor agitation
Low lethality risk in suicide attempts

4-6 wk’s to take effect even 3-4 mo for Thera.levels

Give propranolol, blankets, dantrolene/diatezepam for muscle ridgity
Risk will happen when they combine with another med SSRI,MOAI, Try, SSNI only can take 1
2-5 wk’s can not manage there symptoms

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23
Q

Serotonin norepinephrine reuptake inhibitors

A

MOA: block the absorption or serotonin and norepinephrine in the brain

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24
Q

Tricyclic antidepressants

A

Amoxapine (only generic)

25
Q

Tricyclic antidepressants

A

Desipramine- Norpramin

26
Q

Tricyclic antidepressants

A

Doxepin-Sinequan

27
Q

Tricyclic antidepressants

A

Imipramine- Tofranil

28
Q

Tricyclic antidepressants

A

Maprotiline (generic only)

29
Q

Tricyclic antidepressants

A

Nortriptyline-Pamelor

30
Q

Tricyclic antidepressants

A

Protriptyline-Vivactil

31
Q

Tricyclic antidepressants

A

Trimipramine-Surmontil

32
Q

Tricyclic antidepressants

A

MOA: Inhibit the synaptic reuptake of serotonin and norepinephrine

33
Q

Tricyclic antidepressants

A

SE:
Dry mouth
Blurred vision
Photophobia
Tachycardia
Constipation
Urinary retention & hesitancy
Hypotension
Sedation

34
Q

Tricyclic antidepressants

A

-Must take therapeutic doses for TCAs for 10-14 days or longer before they begin to work
-Initial dose should always be low and ⬆️ gradually
Only good to take for 7 days the more days they take risk of toxicity
-considered risk in older adults, patients w/ cardiac ❤️dz.
-should have a thorough cardiac ❤️ workup before beginning TCA therapy
-Overdose carries a risk of death ☠️ from cardiac conduction abnormalities
-Cardiac toxicity, seizures, coma

35
Q

Monoamine oxidase inhibitors MAOI

A

Isocarboxazid-Marplan

36
Q

Monoamine oxidase inhibitors MAOI

A

Selegiline-Emsam transdermal patch ‼️ apply in a dry intact skin upper torso, thigh, outer surface of arm. At the same time of each day and switch sites. If patch falls off place another one asap and continue at its scheduled time

Avoid exposing to any form of heat

37
Q

Monoamine oxidase inhibitors MAOI

A

Tranylcypromine-Parnate

38
Q

Monoamine oxidase inhibitors MAOI

A

MOA: responsible for interacting or breaking down, monoamine neurotransmitter in the brain 🧠 such as norepinephrine, serotonin, dopamine & tyramine

Tyramine diet restrictions= hypertensive crisis occurs Stroke, death, coma, seizures, inter cranial hemorrhage take 15 mins after taking the tyramine food= Irritable, anxiety, flushing, sweating, severe headache= ER ASAP‼️ charcoal, fluid therapy, cooling blankets TX.

39
Q

Monoamine oxidase inhibitors MAOI

A

SE:
Insomnia
Nausea
Agitation
Confusion
Orthostatic hypotension
Muscle twitching
Sedation

40
Q

Monoamine oxidase inhibitors MAOI

A

Diet restrictions: HIGH Tyramine
-Aged cheese 🧀
-Red wine 🍷 and beer 🍺
-Smoked & processed meat 🥩
-Dried or cured fish 🐟
-Other food caviar, shrimp paste 🍤, soy sauce, sauerkraut

41
Q

Monoamine oxidase inhibitors MAOI

A

Diet Restrictions: MODERATE Tyramine
-Gouda cheese
-Processed cheese 🧀
-Mozzarella
-Yogurt
-sour cream
-avocado 🥑
- bananas 🍌
-Colas
- Tea 🍵
- Chocolate 🍫

42
Q

Monoamine oxidase inhibitors MAOI

A

Diet Restrictions: LOW Tyramine
-Pasteurized cheese 🧀 (cream cheese, cottage cheese)
-Ricotta
-Figs
-Distilled spirits

43
Q

Atypical Antidepressants

A

Maprotiline

44
Q

Atypical Antidepressants

A

Mirtazapine- Remeron

45
Q

Atypical Antidepressants

A

Nefazodone

46
Q

Atypical Antidepressants

A

Trazadone

47
Q

Major Depressive Disorders

A

Patient needs to have 2 weeks of having sad moods and 4-5 symptoms will be a dx of MDD

48
Q

Major Depressive Disorder

A

S/S of MDD: Fatigue or loss of energy
Hypersomnia/ sleep disturbances
Changes in appetite
Physo motor retardation
Feelings hopeless/worthless
Inability to think/concentrate
Changes in physical activity
Persistent thoughts/death & suicide

49
Q

Major Depressive Disorders types

A

With or Without Psychotic features
Peripartum onset
Seasonal pattern

50
Q

Peripartum Onset

A

Occurs a couple days after delivery a baby
4 weeks come after delivering the baby fatigue, appetite lost, sleep disturbances

Post Partum depression days after birth s/s similar to depressive disorder like psychotic, hallucinations, poor insight, poor judgment, loss of reality contact it is a medical emergency 🚨 danger to baby

51
Q

Season pattern-MDD

A

Called winter depressive disorder due to less sun light ppl can develop seasonal disorder. When the spring and summer are here symptoms will disappear.
S/s are similar to depressive disorder just no suicide thoughts
TX: light therapy 1st line

52
Q

Persistent Depressive Disorder aka dysthymia

A

Occur most of the day for a majority days. A mild form of depression. Early onset can start in childhood and adolescents.
Must have 3 clinical findings of depression
2yrs for adults
1yr for child/adolescent

53
Q

Persistent Depressive Disorder aka dysthymia

A

Mild than MDD s/s
Changes of appetite
Fatigue

54
Q

Premenstrual Dysphoric Disorder

A

Symptoms disappear after menstruating and start the week before menstruating
S/s markedly depressed mood
Excessive anxiety
Mood swings
Decreased interest in activities

55
Q

Substance- induced depressive disorder

A

Substance is causing them to physiological depressive
Alcohol
Meth
Cocaine
Symptoms appear one month after using

56
Q

Depression Assessment SIG E CAP

A

Sleep disturbances
Interest decreased in pleasure activities & sex
Guilty feelings

Energy decreased

Concentration
Appetite
Psychomotor function ⬇️
Suicidal Ideations

57
Q

Assessment Tools to screen for depression

A

Beck Depression inventory
Hamilton Depression scale
Children’s depression rating scale CDRS
The geriatric depression scale

58
Q

Atypical Antidepressants

A

Esketemine- Spravato nasal spray aka ketamine
Date rape drug not really prescribed
Only used for tx depression resistance so when nothing other meds work

59
Q

Atypical Patient Education

A

Therapeutic effects may to be experienced for 1-3 wk’s. Full therapeutic effects may take 2-3 mo
-sudden discontinuation can result in relapse
-therapy usually continue 6 mo after resolution of manifestation and it may continue for 1yr or longer
-suicide prevention is facilitated by prescribing only a week worth of medication for an acutely I’ll client & inky prescribing 1 mo worth of med at a time especially w/ TCA which have a ⬆️ risk for lethality w/ overdose
-antidepressants induced suicide is mainly associated w/ clients under the age of 25

MENTALHEALTH (3 decks)

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