Test 4 Antidepressant Shi Flashcards
What are the classes of antidepressants?
SSRI: Block reuptake of serotonin
SNRI: Block serotonin and norepinephrine reuptake
NDRI: Block reuptake of norepiniphrine and dopamine
TCAs: Tricyclic ADs- affect multiple neurotrasnmitters
MAO: Blocl recycling of serotonin, norepi, and dopamine
How do Tricyclic anitdepressants work?
Inhibit reuptake of 5HT and NE
Some used for chronic, intractable pain, neuropathy, fibromyalgia, and anxiety disorders
What shouuld you teach patients about TCA’s?
Teach them that they might feel better after 10-14 days of using
Indications of TCA’s
Depression
Bedwetting
Fibromyalgia
OCD
Contraindications of TCA’s
Recent MI, myelography, concurrent use of MAOI (can cause seratonin syndrome)
Risk for suicidality
History of seizures ; caution
Hepatic/ renal disease ; caution
Adverse effects of TCA’s
CNS and peripheral nervous system
GI anticholinergic effects
GU
Anitcholinergic effects
WIthdrawel syndrome
Drug interactions of TCA’s
Cimetidine
Fluoxetine
Ranitidine
Oral anticoagulants
Severe TCA toxicity
S- Shock
A- Altered mental status
L- Long QRS interval duration
T- Terminal R wave in aVR
What are the 3 C’s ? (major collection of side effects of TCA’s)
Convulsions
Coma
Cardiotoxicity
What are some TCA examples?
Amitriptyline
Nortriptyline
Amoxapine
What do MAOI inhibitors do?
Inhibit monoamine oxidase in the nerve terminals, which increases amount of norepinephrine and seratonin available
Examples of MAOIs
Isocarboxazid: Depression brah
Phenelzine: Bulimia nervosa lol
Tranycypromanine : OCD lmao
Selegilline: Panic attacks noooo
MAOI drug interactions
Antihypertensive drugs
Meperidine
Other antidepressants
Insulin or oral antidiabetic drugs
What patient teaching should you give when a patient is taking an MAOI
Don’t eat aged foods
Wine
Cheese
ANything w tyramine
Smoked fish
Contraindications of MAOIs
Pheochromocytoma
CV disease
Known Abnormal CNS vessels or defects, history of headaches
renal or hepatic impairment
Boxed warning for possible risk of suicidality
Caution: Bipolar disorder, patients undergoing selective surgery soon
Adverse effects of MAOIs
More serious and/ or fatal than other antidepressants
GI
CV
Sweating
Tremors
Elevated temp
Bounding Heart
Raised BP
SSRIs therapeutic actions
Block reuptake of 5HT, increasing levels in synaptic cleft
Inidcations of SSRIs
Treatment of depression
OCD
Panic Attacks
Bulimia
PMDD
Postramatic stress disorders
social phobias
Social anxiety disorders
How long do SSRI’s usually take to work
4 weeks / a month
SSRI mnemonic for drugs
Effective For Sadness Panic & Compulsions
E= escitalopram (lexapro)
F= Fluoxetine/ Fluvoxamine
S= Sertraline
P= Paroxetine
C= Citalopram
SSRI mnemonic for side effects
Bad SSRI
B- Body weight increase
A- ANorexia
D- Diarrhea/ nausea
S- Suicidal thoughts
S- Seratonin syndrome
R- Reproductive sexual dysfx
I- Insomnia
SNRI therapeutic actions
Decrease neuronal reuptake of both seratonin and norepiniphrine and more weakly inhibit dopamine
Indicated for treatment of major depressive disorder EXCEPT milnacipran (indicated for fibromyalgia)
Difference between SSRI and SNRI
SSRI
* Mood regulator
* Blocks receptors in brain which increases amt of seratonin available
* effects appear around 6 months to a few months
SNRI
* Improve communication and regulates mood
* Blocks reabsorption of neurotransmitters seratonin to increase levels in brain
* Effects appear anywhere from 2- 8 weeks
SNRI contraindications
Severe depression caution
Suicidality cuat
Bipolar Disorder caut
Preg/lact caut
Contrainidcated in MAOI use
