overview of med classes Flashcards
SSRI
Action
Inhibit reuptake of serotonin (5-HT)
Desired Effect:
Reduce depression
Control anxiety
Control obsessions
Side effect:
Nausea, agitation, headache, sexual dysfunction
Tricyclic antidepressants
Action:
Inhibit reuptake of serotonin (5-HT)
Inhibit reuptake of NE
Block NE (α1) receptor
Block ACh receptor
Block histamine (H1) receptor
Desired Effect:
Reduce depression
Relieve severe pain
Prevent panic attacks
Side Effect:
Sexual dysfunction (NE and 5-HT)
Sedation, weight gain (H1)
Dry mouth, constipation, blurred vision, urinary retention (ACh)
Postural hypotension and tachycardia (α1)
MAOI
Action:
Increase NE and 5-HT by inhibiting the enzyme that degrades them (MAO-A)
Desired effect:
Reduce depression
Control anxiety
Side Effect:
Sedation, dizziness
Sexual dysfunction
Hypertensive crisis (interaction with tyramine and foods or beverages with high caffeine content)
Trazodone and nefazodone
Action:
5-HT reuptake block
5-HT2 receptor antagonism
Adrenergic receptor blockade
Desired effect:
Reduce depression
Reduce anxiety
Side effect:
Nausea (5-HT)
Sedation (5-HT2)
Orthostasis (α1)
Priapism (α2)
Selective norephinephrine reuptake inhibitors (SNRIs):
Action:
Potent inhibitors of serotonin and norepinephrine reuptake
Weak inhibitors of dopamine reuptake
Desired Effect:
Reduce depression
Relieve pain of neuropathy (duloxetine)
Relieve anxiety (venlafaxine)
Side effect:
Nausea (5-HT)
↑ Sweating (NE)
Insomnia (NE)
Tremors (NE)
Sexual dysfunction (5-HT
Bupropion
action:
Inhibits reuptake of NE and D
Desired effect:
Reduces depression
Aids in smoking cessation
Reduces symptoms of ADHD
s/e
Insomnia, dry mouth, tremor, seizures
Antipsychotics: phenothiazines and haloperidol
Action:
Strong D2 receptor blockades
Weaker blockades of ACh, H1, α1-adrenergic, and 5-HT2 receptors
Desired effect:
Relieve psychosis
Relieve anxiety
(Some) provide relief from nausea and vomiting and intractable hiccoughs
S/E
Blurred vision, dry mouth, ↓ sweating, constipation, urinary retention, tachycardia (ACh) EPS (D2)
↑ Plasma prolactin (D2)
Sedation; weight gain (H,)
Ejaculatory difficulty (5-HT2)
Postural hypotension (α; H1)
Antipsychotics (second generation, atypical): aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone
Action:
Receptor antagonism of 5-HT1A and 5-HT2A
D1–D5 (varies with drug)
H1, α1-adrenergic muscarinic (ACh)
Desired effect:
Relieve psychosis (with minimal or no EPS)
Relieve anxiety
Relieve acute mania
S/E
Potential with some of the drugs for mild EPS (D2)
Sedation, weight gain (H1)
Orthostasis and dizziness (α-adrenergic)
Blurred vision, dry mouth, ↓ sweating, constipation, urinary retention, tachycardia (ACh)
Antianxiety:
benzodiazepines
Action:
Bind to BZ receptor sites on the GABAA receptor complex; increase receptor affinity for GABA
Desired effect:
Relieve anxiety
S/E
Produce sedation
Dependence (with long-term use)
Confusion, memory impairment, motor incoordination
Anticonvulsants used for anxiety
divalproex, gabapentin, and pregabalin
As well as carbamazepine, clonazepam, topiramate, and lamotrigine)
Beta Blockers used as alternatives for anxiety meds
atenolol, propranolol, and nadolol
Antihistaminic meds for anxiety
hydroxyzine.
Antidepressant Med Indication
major depressive and dysrhythmic
Bipolar disorder
is characterized by cycles of depression and manic episodes, which may manifest as grandiose thinking and behavior, rapid thoughts, hyperactivity, or impulsive agitation
Discontinuation syndrome:
Nursing interventions
Instruct patients that all antidepressants have some potential for discontinuation syndrome and should not be stopped abruptly but rather tapered off. Paroxetine is associated with the highest risk for discontinuation syndrome (Janicak & Hussain, 2017).
