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MENTALHEALTH > Depressive Disorders CH. 14 > Flashcards

Depressive Disorders CH. 14 Flashcards

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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

Study These Flashcards
A

Amoxapine (only generic)

25
Tricyclic antidepressants
Desipramine- Norpramin
26
Tricyclic antidepressants
Doxepin-Sinequan
27
Tricyclic antidepressants
Imipramine- Tofranil
28
Tricyclic antidepressants
Maprotiline (generic only)
29
Tricyclic antidepressants
Nortriptyline-Pamelor
30
Tricyclic antidepressants
Protriptyline-Vivactil
31
Tricyclic antidepressants
Trimipramine-Surmontil
32
Tricyclic antidepressants
MOA: Inhibit the synaptic reuptake of serotonin and norepinephrine
33
Tricyclic antidepressants
SE: Dry mouth Blurred vision Photophobia Tachycardia Constipation Urinary retention & hesitancy Hypotension Sedation
34
Tricyclic antidepressants
-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
Monoamine oxidase inhibitors MAOI
Isocarboxazid-Marplan
36
Monoamine oxidase inhibitors MAOI
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
Monoamine oxidase inhibitors MAOI
Tranylcypromine-Parnate
38
Monoamine oxidase inhibitors MAOI
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
Monoamine oxidase inhibitors MAOI
SE: Insomnia Nausea Agitation Confusion Orthostatic hypotension Muscle twitching Sedation
40
Monoamine oxidase inhibitors MAOI
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
Monoamine oxidase inhibitors MAOI
Diet Restrictions: MODERATE Tyramine -Gouda cheese -Processed cheese 🧀 -Mozzarella -Yogurt -sour cream -avocado 🥑 - bananas 🍌 -Colas - Tea 🍵 - Chocolate 🍫
42
Monoamine oxidase inhibitors MAOI
Diet Restrictions: LOW Tyramine -Pasteurized cheese 🧀 (cream cheese, cottage cheese) -Ricotta -Figs -Distilled spirits
43
Atypical Antidepressants
Maprotiline
44
Atypical Antidepressants
Mirtazapine- Remeron
45
Atypical Antidepressants
Nefazodone
46
Atypical Antidepressants
Trazadone
47
Major Depressive Disorders
Patient needs to have 2 weeks of having sad moods and 4-5 symptoms will be a dx of MDD
48
Major Depressive Disorder
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
Major Depressive Disorders types
With or Without Psychotic features Peripartum onset Seasonal pattern
50
Peripartum Onset
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
Season pattern-MDD
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
Persistent Depressive Disorder aka dysthymia
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
Persistent Depressive Disorder aka dysthymia
Mild than MDD s/s Changes of appetite Fatigue
54
Premenstrual Dysphoric Disorder
Symptoms disappear after menstruating and start the week before menstruating S/s markedly depressed mood Excessive anxiety Mood swings Decreased interest in activities
55
Substance- induced depressive disorder
Substance is causing them to physiological depressive Alcohol Meth Cocaine Symptoms appear one month after using
56
Depression Assessment SIG E CAP
Sleep disturbances Interest decreased in pleasure activities & sex Guilty feelings Energy decreased Concentration Appetite Psychomotor function ⬇️ Suicidal Ideations
57
Assessment Tools to screen for depression
Beck Depression inventory Hamilton Depression scale Children’s depression rating scale CDRS The geriatric depression scale
58
Atypical Antidepressants
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
Atypical Patient Education
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

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