Session 6: Anxiety & CNS Depressants Flashcards
o Tricyclic Antidepressants (TCAs)
o Selective Serotonin Reuptake Inhibitors (SSRIs)
o Serotonin-Norepinephrine Reuptake Inhibitors
(SNRIs)
o Monoamine Oxidase Inhibitors (MAOIs)
Drug Classes for Anxiety & Depression
o Benzodiazepines
o Barbiturates
Drug Classes for CNS Depressants
Low blood pressure that occurs when standing from sitting or lying down
Orthostatic/ postural Hypotension
Too much serotonin in synapses of brain
Serotonin syndrome
is an amino acid that helps regulate blood pressure. It occurs naturally in the body, and it’s found in certain foods.
Medications called monoamine oxidase inhibitors (MAOIs) block monoamine oxidase, which is an enzyme that breaks down excess ______ in the body.
Tyramine
Imbalance of neurotransmitters may lead to signs & symptoms of a CNS disorder.
- norepinephrine
- serotonin
Function of Neurotransmitters
abnormal levels associated with depression, anxiety, and panic attacks.
Norepinephrine
abnormal levels impact mood, sleep, libido, and temperature. Linked to depression, bipolar, and anxiety.
Serotonin
• Disturbance in mood, behavior, and most body systems
• occurs when the intensity and duration of _______ does not match the potential for harm or threat.
Anxiety
• Nonpharmacological Interventions: relaxation
techniques, exercise and psychotherapy
•Pharmacological: Anti-Anxiety Medications
Treatments of Anxiety
• Aches and pains
• Stomach aches
• Headaches
• Tachycardia
• Trembling
• Sweating
• Difficulty concentrating
• Increased agitation
• Crying
S/S of anxiety
• Affects 5% of the population
• Most common mental health condition of elderly.
• The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The symptoms cannot be from effects of a substance or from bereavement.
Depression
- Therapies: Psychotherapy, Cognitive,
Electroconvulsive, and Group - Medications
Treatment for Depression
• Depressed Mood
• Diminished Interest
• Weight Gain or Loss
• Excessive or Inadequate Sleep
• Agitation
• Fatigue
• Feelings of Worthlessness
• Inappropriate Guilt
• Lessened Ability to Concentrate
• Recurrent thoughts of Death, Suicidal Ideation, or Suicide Attempts
S/S of Depression
A depressed affect plus 5 symptoms lasting more than 2 weeks.
Major Depressive Disorder
Treat depression and other mental health disorders, also treat migraines, chronic pain, and premenstrual syndrome.
general classification
Antidepressants Therapeutic Use
Increase levels of neurotransmitters in the CNS, including serotonin, dopamine, & norepinephrine, thereby treating an underlying cause of depression.
general classification
Action of Antidepressants
Tricyclics and MAOIs
1st generation antidepressants
All patients receiving antidepressants should be monitored for signs of worsening depression or changing behavior, especially when medication is started or if the dose is changed.
Nursing Considerations with Antidepressants
- monitor for suicidal ideation
- teach family/ pt. About s/s of suicidal ideation
- do not mix with CNS depressants or alcohol
- discontinue gradually if possible
Monitor/Do/Teach for Antidepressants
SSRIs and SNRIs
2nd generation antidepressants
alter the brain by decreasing excitability of neurotransmitters, blocking their receptor site, or increasing the inhibitory neurotransmitter.
CNS depressants
mental status changes (e.g., agitation, hallucinations, delirium, and coma), autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, with or without gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
Serotonin syndrome
dry mouth, constipation, urinary retention, bowel obstruction, dilated pupils, blurred vision, increased heart rate, and decreased sweating
Anticholinergic Effects
