SSRIs

Question 1

difference b/w TCAs and SSRIs

Answer 1

• SSRIs are equally effective, better tolerated, and safer

Question 2

what is serotonin syndrome?

Answer 2

• starts 2-72 hours after taking an SSRI
• S/S:
  
  • altered mental status
  • incoordination
  • myoclonus
  • hyperreflexia
  • excessive sweating
  • tremor
  • fever
• may cause death

Question 3

SSRIs: nursing implications

Answer 3

• contraindicated: pts taking MAOIs
• caution in pregnant patients and older adults
• make sure to take meds as prescribed even if feel cured
  
  • should continue 4-9 mos
• usually take 1-3 weeks for effects to develop
• administer in the morning to minimize sleep problems
• take with food to minimize GI upset
• do not d/c abruptly

Question 4

paroxetine: class

Answer 4

• SSRI

Question 5

paroxetine: indcations

Answer 5

• major depression
• OCD
• panic disorder
• social phobia
• GAD
• PTSD
• PMDD

Question 6

• paroxetine: MOA

Answer 6

• SSRIs selectively block neuronal reuptake of serotonin (5HT)
  
  • so the conc of 5HT in the synapse inc and causes inc activation of 5HT receptors
• relief of depression takes several weeks to fully develop even though receptors blocked w/in hours

Question 7

paroxetine: SE

Answer 7

• nausea
• somnolence
• sweating
• tremor
• fatigue
• headache
• weight gain
• sexual dysfunction
• CNS stimulation: insomnia, inc waking
• antimuscarinic effects

Question 8

paroxetine: ADRs

Answer 8

• neuroleptic malignant syndrome
• seizures
• suicidal thoughts
• Torsades de Pointes
• serotonin syndrome
• neonatal effects:
  
  • neonatal abstinence syndrome
  • persistent pulmonary HTN of the newborn (PPHN)
  • VSD
• GI bleed

Question 9

sertraline: class

Answer 9

• SSRI

Question 10

sertraline: indications

Answer 10

• major depression
• OCD
• panid disorder
• social phobia
• PTSD
• PMDD
• off label: GAD

Question 11

sertraline: MOA

Answer 11

• SSRIs selectively block neuronal reuptake of serotonin (5HT)
  
  • so the conc of 5HT in the synapse inc and causes inc activation of 5HT receptors
• relief of depression takes several weeks to fully develop even though receptors blocked w/in hours

Question 12

sertraline: SE

Answer 12

• headache
• CNS stimulation: insomnia, agitation, nausea, diarrhea, tremor
• weight gain
• sexual dysfunction

Question 13

sertraline: ADRs

Answer 13

• neuroleptic malignant syndrome
• seizures
• suicidal thoughts
• Torsades de Pointes
• serotonin syndrome
• neonatal effects:
  
  • neonatal abstinence syndrome
  • persistent pulmonary HTN of the newborn (PPHN)
  • VSD
• GI bleed