Mental Health Module 4 Flashcards
Biogenic amines
norepinephrine
serotonin
dopamine
4 types of antidepressants
tricyclic antidepressants
monoamine oxidase inhibitors (MAO-i)
selective serotonin reuptake inhibitor (SSRI)
selective serotonin norepinephrine reuptake inhibitors (SNRI)
MAOI MOA
prevent breakdown of biogenic amines
SSRI MOA
block reuptake of serotonin in the synaptic cleft
SNRI MOA
block reuptake of serotnin/norepinephrine in the synaptic cleft
MAOI & diet specifications
cannot eat foods high in tyramine –> can lead to potentially fatal levels of NE (hypertension, cardiac arrhythmias, etc)
Major Depressive Disorder
Bipolar depression
depression characterized by periods of mania & major depression
categorized as bipolar I, bipolar II, unspecified
Hypomania
> /= to 4 days
different than baseline behavior
has at least >/= 3 manic symptoms
does not interfere with ADLs/work/school
does not require hospitalization
Acute mania
> /= to week
severe impact on ADL/work/school
may require hospitalization
elated, expanded mood
risky behaviors
lack of appetite/sleep
greater talkativeness
flight of ideas/racing thoughts
increased goal-directed activity
inflated self-esteem/grandiosity
Bipolar medication
lithium
Bipolar I disorder
one full-fledged manic episode & depressive episode
Bipolar II disorder
major depressive episodes & at least on hypomanic episode
no full-fledged mania
Depression symptoms
depressed mood
anhedonia
weight gain/weight loss
insomnia
psychomotor agitation/retardation
fatigue/loss of energy
feelings of worthlessness, excessive/inappropriate guilt
lack of concentration/decisiveness
suicidal ideation
Risk of antidepressants
when first initiating treatment/increasing dose
results in an increase in energy which can increase risk of suicide
high safety risk if there is an increase in energy & depressed mood
Mood stabilizers
anticonvulsants
lithium
atypical antipsychotics
Are children likely to experience psychosis
no
3 Treatments for depression
ECT
medication
psychotherapy
Stimulants used to treat depression
dexedrine
ritalin
Why are stimulants used to treat depression
treatment resistant depression –> for quick response
debilitated patients, stroke or chronic medical illness
Types of psychotherapy
CBT
interpersonal
psychodynamic
individual counselling
family counselling
group counselling
milieu therapy
Anticonvulsants
divalproex sodium
carbamazepine
gabapentin
lamotrigine
topiramate
valproic acid
MOA of mood stabilizers
calm down hyperactivity in brain kindling
Nursing considerations of lithium
narrow therapeutic window –> monitor serum levels. hold lithium if blood work not completed yet
interaction with sodium –> inverse reabsorption with sodium (higher salt lower lithium and vice versa)
fluid loss can lead to higher lithium levels
monitor s/s of lithium toxicity
