Pharmocology

Question 1

Selective serotonin reuptake
inhibitors (SSRIs)
citalopram
fluoxetine
sertraline
Serotonin-norepinephrine
reuptake inhibitors (SNRIs)
duloxetine
venlafaxine

Answer 1

Considerations:
Do not stop SSRIs abruptly, as this can cause discontinuation syndrome.
Inform client that sexual side effects are common.
Take with food and drink fluids to decrease GI upset.
For clients taking SNRIs: Obtain baseline BP and monitor throughout treatment.

Question 2

Tricyclic antidepressants (TCAs)
amitriptyline
imipramine
nortriptyline

Answer 2

Cautions:
Complete an ECG before starting a TCA and periodically throughout
treatment to assess for dysrhythmias.
Avoid activities requiring alertness (driving) until response to the medication
is known.
Considerations:
Orthostatic hypotension: Teach client to change positions slowly.
Anticholinergic effects: Encourage sugar-free hard candy to relieve dry
mouth and monitor for urinary retention.

Question 3

Monoamine oxidase inhibitors
(MAOIs)
isocarboxazid
phenelzine
selegiline

Answer 3

Cautions:
Do not combine with other antidepressants (SSRIs, TCAs).
A washout period of ≥2 weeks is required upon starting or stopping an MAOI.
Risk for hypertensive crisis: Client must avoid high-tyramine foods (cured
meats, aged cheeses, beer, wine).

Question 4

Miscellaneous antidepressants
bupropion
mirtazapine

Answer 4

Bupropion
Avoid in clients at increase risk for seizures (seizure disorder).
Mirtazapine
Risk for sedation: Advise clients to avoid activities requiring alertness.
Likely to cause weight gain