Nervous System medications Flashcards
Benzos
“am”
am except for clorazepate and chlordiazepoxide
for oral toxicity
ALWAYS check LOC
Serotonin Syndrome
lethal complication
usually begins 2-72 hrs after initiation of tx with SSRI
concurrent use of an SSRI with an MAOI
concurrent use of an SSRRI with a TCA
Serotonin Syndrome findings
- agitation
- confusion
- disorientation
- difficulty concentrating
- anxiety
- hallucinations
- hyperreflexia
- incoordination
- tremors
- fever
- diaphoresis
- hostility
- delirium
- seizures
- tachycardia
- lebile blood pressure (fluctuates between normal and high)
- nausea and vomitng
- diarrrhea/ abd. pain
- coma leading to apnea
- death
SSRI’s
first line treatment for depression
can take 1-3 weeks or longer
Bupropion
Atypical antidepressant
inhibits noreepi. and dopamine uptake.
alt. to SNRI’s and SSRI’s who are not able to tolerate sexyal dysfunction symptoms
AID FOR SMOKIN CESSATION
alt. for ADD
Other atypical antidepressants
brpropion
vilazodone
mirtazapine
nefazodone
trazodone ER
Bupropion
complications and contraindications
headache, dry out, GI distress, constipation, increased HR, htn, restlessness, insomnia
nausea, vomiting, anorexia, weight loss
seizures
CONTRAINDICATED:
MAOI’s
seizure disorderr
eating disorderr
Trazodone ER
usually used with another antidepressant
SEDATION potential problem
if priapism occurs seek medical attention immediately***
no grapefruit
Big things about TCA’s
can take 10-14 days and up to 4-8 weeks for effects
complications- ortho. hypotension, anticholinergic effects, sedation, decreased seizure threshold, excessive sweating
TCA toxicity
cholinergic blockade and cardiac toxicity
dysrhythmias, mental confusion, agitation
- seizures, coma, death
** obtain baseline ECG, vs frequently, monitor signs of toxicity
How to minimize anticholinergic effects
chew sugarless gum
sipping on water
wear sunglasses outdoors
eat high fiber foods
regular exercise
increase fluid intake 2-3 L
void before medication
TCA’s contraindications and precautions
CAT C
seizure disorder or recent MI
Caution with;
elderly
CAD
diabetes
liver or kidney
resp. disorders
urinary retention/ obstruction
BPH
glaucoma
hyperthyroidism
MAOI’s
Phenelzine
isocarboxaazid
tranylcypromine
selegiline (transdermal MAOI)
usually takes 2-4 weeks
MAOI’s complications
- CNS stimulations
- orthostatic hypotension
- local rash with transdermal
HYPERTENSIVE CRISIS, SEVERE HTN, HEADACHE, NAUSEA, INCREASED HR, INCREASED BP
Tyramine rich foods
aged cheese
pepperoni
salami
avocados
figs
bananas
smoked fish
protein dietary supplements
soups
soy sauce
beers
red wine
