Wk 4 Depression & Anxiety Pharmacology

Question 1

First line because of safety risks

Answer 1

SSRIs and SNRIs

Question 2

Most depression and anxiety disorders are results of..

Answer 2

Some sort of neurotransmitter imbalance

Question 3

Always assess

Answer 3

suicide risk

Question 4

After starting drug, patient should be monitored for

Answer 4

6-8 weeks for efficacy

Question 5

If patient has suicidal

Answer 5

may start meds on inpatient or daily outpatient basis

Question 6

Takes __ to work

Answer 6

4-8 weeks

Question 7

SSRI

Answer 7

Selective serotonin reuptake inhibitor

Question 8

SSRI MOA

Answer 8

Inhibits serotonin at the nerve endings

More serotonin at nerve endings

Question 9

GI adverse effects of SSRIs

Answer 9

Nausea, vomitting, diarrhea, constipation, dry mouth

Question 10

CNS adverse effects of SSRIs

Answer 10

Headache, nervousness, insomnia

Question 11

SSRIs other adverse effects

Answer 11

Sexual dysfunction, weight gain, serotonin syndrome, withdrawal syndrome, suicide risk

Question 12

Occurs 2-72 hours after treatment, altered mental status, person becomes overloaded with serotonin

Answer 12

Serotonin syndrome

Question 13

Serotonin syndrome usually occurs when you take two drugs that would

Answer 13

inhibit serotonin reuptake (MAOIs and SSRIs)

Question 14

Withdrawal syndrome symptoms

Answer 14

Dizziness, headache, sensory disturbances, tremors, increased anxiety, dysphoria

Question 15

Taking SSRIs while pregnant can increase risk of

Answer 15

Pulmonary hypertension in neonate and abstinence syndrome

Question 16

fluoxetine (Prozac)

Answer 16

SSRI

Question 17

sertraline (Zoloft)

Answer 17

SSRI

Question 18

paroxetine (Paxil)

Answer 18

SSRI

Question 19

citalopram (Celexa)

Answer 19

SSRI

Question 20

escitalopram (Lexapro)

Answer 20

SSRI

Question 21

Typically only __ generation SSRIs are prescribed

Answer 21

second

Question 22

2 Nursing considerations for SSRIs

Answer 22

Don’t use with MAOIs and it takes 3-4 weeks to work

Question 23

venlafaxine (Effexor)

Answer 23

SNRI

Question 24

desvenlafaxine (Pristq)

Answer 24

SNRI

Question 25

duloxetine (Cymbalta)

Answer 25

SNRI

Question 26

SNRI

Answer 26

selective norepinephrine reuptake inhibitor

Question 27

SNRI symptoms

Answer 27

Nausea, headache, anorexia, insomnia, somnolence, sexual dysfunction, withdrawal syndrome, sweating, blurred vision, increased LFTs (duloxetine)

Question 28

Which SNRI can cause increased LFTs?

Answer 28

duloxetine

Question 29

older generation of antidepressants

Answer 29

TCAs, MAOIs

Question 30

TCA to know

Answer 30

amitriptyline (Elavil)

Question 31

TCAs are very __ compared to newer drugs such as SSRIs or SNRIs

Answer 31

inexpensive

Question 32

TCAs are associated with...

Answer 32

FATAL OVERDOSES

Question 33

Norepinephrine and serotonin are called __ neurotransmitters

Answer 33

monamine

Question 34

What are the anticholinergic effects?

Answer 34

Overheated, dry mucous membranes, blurry vision, red/flushed, confusion

Question 35

TCAs have __ effects

Answer 35

anticholinergic

Question 36

MAOI to know

Answer 36

phonelzine

Question 37

Where is monoamine oxidase found?

Answer 37

Liver, intestinal walls, and terminals of neurons

Question 38

What can you not take when on MAOIs?

Answer 38

Tryamine

Question 39

What has tyramine in it?

Answer 39

Aged cheeses, smoked meat, yeast, red wine

Question 40

Benzodiazepines use the CYP pathway so...

Answer 40

Avoid taking with grapefruit juice and fatty foods

Question 41

Antidote to benzodiazepines

Answer 41

flumazenil (Romazicon)