SSRI

Question 1

SSRI

Answer 1

Selective serotonin reuptake inhibitors

Question 2

paroxetine

Answer 2

Paxil or Seroxat

Question 3

sertraline

Answer 3

Zoloft

Question 4

citalopram

Answer 4

Celexa

Question 5

escitalopram

Answer 5

Cipralex or Lexapro

Question 6

fluoxetine

Answer 6

Prozac or Sarafem

Question 7

fluvoxamine

Answer 7

Luvox

Question 8

Pharmacological action

Answer 8

Selectively inhibits serotonin reuptake, allowing more serotonin to stay at the junction of the neurons.
Produces CNS stimulation which can cause insomnia.

Question 9

Therapeutic use of Paroxetine

Answer 9

GAD
Panic disorder (decrease frequency and intensity of panic attacks)
OCD
Social anxiety disorder
Trauma and stressor-related disorders
Dissociative disorders
Depressive disorders
Adjustment disorders

Question 10

Therapeutic uses of Sertraline

Answer 10

Panic disorder
OCD
social anxiety disorder
PTSD

Question 11

Therapeutic uses of Escitalopram

Answer 11

GAD

OCD

Question 12

Therapeutic uses of Fluoxetine

Answer 12

Panic disorder
OCD
PTSD

Question 13

Therapeutic uses of Fluvoxamine

Answer 13

OCD

Social anxiety disorder

Question 14

Complications

Answer 14

Early adverse effects
Later adverse effects
Weight gain
GI bleeding
Hyponatremia
Serotonin Syndrome
Bruxism
Withdrawal Syndrome
Postural hypotension
Suicidal ideation

Question 15

Nursing considerations for early adverse effects

Answer 15

look for nausea, diaphoresis, tremor, fatigue, and drowsiness in the first few days/weeks.
Report to provider
take med as prescribed
advise pt that the effects should soon subside

Question 16

Nursing considerations for late adverse effects

Answer 16

After 5-6 weeks of therapy: sexual dysfunction

Instruct client to report problems (provider may reduce dose, take a break from the med, or change med

Question 17

Nursing considerations for weight gain

Answer 17

advise pt to follow a well-balanced diet and exercise

Question 18

Nursing considerations for GI bleeding

Answer 18

Use caution with pts with hx of GI bleed or ulcers or taking anticoagulants.
Advise pt to report black stool or coffee-ground emesis

Question 19

Nursing considerations for hyponatremia

Answer 19

More likely to happen in older adults taking diuretics.

Obtain baseline serum sodium and monitor level periodically throughout treatment.

Question 20

Nursing considerations for serotonin syndrome

Answer 20

Look for and report: agitation, confusion, disorientation, difficulty concentrating, anxiety, hallucinations, myoclonus (spastic jerky muscle contractions), hyperreflexia, incoordination, tremors, fever, diaphoresis.
Usually begins 2-72 hrs after initiation of tx
Resolves when med is discontinued

Question 21

Nursing considerations for bruxism

Answer 21

grinding and clenching of teeth
report to the provider who might switch the class of medication
treat with low-dose buspirone
advise pt to use a mouth guard during sleep

Question 22

Nursing considerations for withdrawal syndrome

Answer 22

Nausea, sensory disturbances, anxiety, tremor, malaise, unease
taper med slowly
do not stop abruptly

Question 23

Nursing considerations for Postural hypotension

Answer 23

change positions slowly

Question 24

Nursing considerations for suicidal ideation

Answer 24

Monitor and report depression and thoughts of suicide

Question 25

Contraindications

Answer 25

Paroxetine: MAOIs or TCA, alcohol consumption
those with liver and renal dysfunction
seizure disorders
hx of GI bleeding

Question 26

Pregnancy Category

Answer 26

D

Question 27

Interactions

Answer 27

MAOI or TCAs can cause serotonin syndrome

Antiplatelet/anticoag meds increase risk for bleeding

Question 28

Nursing administration

Answer 28

Med can be taken with food.
Take med in the morning to prevent sleep disturbance.
Take on daily basis.
Remind pt it takes up to 4 weeks to become therepeutic

Question 29

Select prototype med

Answer 29

Paroxetine