Mental Health / Withdrawal Flashcards
Medication classes of Antidepressants
Selective serotonin reuptake inhibitors (SSRI)
Serotonin and Norepinephrine reuptake inhibitors (SNRI)
Tricyclic antidepressants
MAO inhibitors
Benzodiazepines
Nursing considerations of antidepressants
SSRI & SNRI are first line- safety risk
Asses suicide risk
After starting drug- monitor 4-8 weeks for efficacy
MOA for SSRI
fluoxetine (Prozac)
inhibitors of serotonin at nerve endings
More serotonin is available at the nerve endings
Adverse effects of SSRI
weight gain GI- N/V/D, constipation, dry mouth CNS- headache, nervousness, insomnia Sexual dysfunction serotonin syndrome withdrawal syndrome Suicidal risk Neonatal effects if pregnant
Serotonin syndrome
2-72 hours after treatment, altered mental status, increased occurrence with MAOIs and other serotonergic drugs
withdrawal syndrome of SSRI
dizziness, H/A, sensory disturbances, tremor, anxiety, dysphoria
fluoxetine (Prozac)
Less sever/fewer s/e
less drug/drug interactions
Avoid use with MAO inhibitors
MAO of venlafazine (Effexor)
Blocks neuronal activity of serotonin and norepinephrine
Adverse effects of venlafazine
nausea, headache, anorexia, insomnia, somnolence, sexual dysfunction, withdrawal syndrome, sweating, blurred vision, increased LFTs (duloxetine)
Tricyclic Antidepressants
amitryptaline (Elavil)
MAO of amitryptaline (Elavil)
Block reuptake of 2 monoamine transmitters, norepinephrine & serotonin (intensify the effect), making more available in the synapse
Adverse effects of amitryptaline (Elavil)
sedation orthostatic hypotension anticholinergic effects sexual dysfunction cardiac toxicity
Monoamine Oxidase Inhibitors (MAOI)
phenelzine (Nardil)
MAO of phenelzine (Nardil)
Inhibits MAO- enzyme found in the liver, intestinal wall and terminals of neurons
MAO converts norepi, 5-HT, and dopamine to inactive product
decreased MAO increases availability of neurotransmitters at the nerve endings
adverse effects of phenelzine (Nardil)
food/drug interactions
CNS stimulation
orthostatic hypotension
rapid increase in BP, stroke, coma
drug interactions!