Term
| What is depression caused by and how is it treated? |
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Definition
-A deficiency of amine neurotransmitters in the brain
-Increasing the levels of brain amines (serotonin) |
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Term
| Name four groups of antidepressants. |
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Definition
-SSRIs (Selective Serotonin Reuptake Inhibitors)
-TCAs (Tricyclic antidepressants)
-MAOIs (Monoamine Oxidase Inhibitors)
-Atypical antidepressants |
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Term
|
Definition
-Fluoxetine (most common)
-Paroxetine
-Sertraline |
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Term
| What is the mechanism of action of SSRIs? |
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Definition
| They block the neuronal reuptake of serotonin. This leads to a greater concentration of serotonin in the synaptic cleft which compensates for the serotonin deficiency in depressed patients. |
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Term
| What are SSRIs used for (4)? |
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Definition
-Depression
-OCD
-Panic disorder
-Bulimia and other eating disorders |
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Term
| What are the ADRs of SSRIs (8)? |
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Definition
-Nausea
-Dry Mouth
-Diarrhea
-Nervousness
-Insomnia
-Headache
-Sweating
-Sexual dysfunction |
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Term
| What is serotinergic syndrome? |
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Definition
| It is an excess of serotonin in the brain. It can be fatal. SSRIs should not taken with MAOIs for this reason. |
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Term
|
Definition
-Amityriptyline
-Imipramine |
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Term
| What is the mechanism of action of TCAs? |
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Definition
| They block the neuronal reuptake of monoamines. This leads to a greater concentration of NE and serotonin in the synaptic cleft which compensates for MA deficiency in depressed patients. They also increase post-synaptic receptor sensitivity to NE and serotonin which has the same effect. |
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Term
| What are TCAs used for (6)? |
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Definition
-Major depression
-Bipolar disorder
-Dysthymia
-Atypical depression
-Some anxiety disorders
-Pain syndromes |
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Term
| Pharmacokinetics of TCAs (2) |
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Definition
-Take orally
-Effects usually seen after 3 weeks |
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Term
| Pharmacokinetics of SSRIs (2) |
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Definition
-Taken orally once a day
-Effects usually seen after 1-4 weeks |
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Term
| What are the ADRs of TCAs (6)? |
|
Definition
-Orthostatic hypotension
-Cardiac effects
-Anticholinergic effects
-Sedation
-OD (narrow TI)
-Not to be used w/ MAOIs (could cause hypertensive crisis) |
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Term
|
Definition
-Phenelzine
-Tranylcypromine |
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Term
| What is the mechanism of action of MAOIs? |
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Definition
| They irreversibly inhibit the enzyme MAO and prevent the degradation of NE and serotonin. The concentration of NE and serotonin is then, increased. |
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Term
| What are MAOIs used for (5)? |
|
Definition
-Atypical depression
-Depression that is unresponsive to other treatments
-Panic disorders
-OCD
-Bulimia |
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Term
| Pharmacokinetics of MAOIs (2) |
|
Definition
-Taken orally
-Effects take 2-3 weeks and last up to 2 weeks after stopping treatment |
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Term
| What are the ADRs of MAOIs (6)? |
|
Definition
-Orthostatic hypotension
-Sedation
-Anticholinergic effects
-Cardiac effects
-Risk of OD
-Interactions with foods that contain tyramine (may cause hypertensive crisis which could result in stroke, coma, or death) |
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Term
| Name two atypical antidepressants. |
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Definition
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Term
|
Definition
| An excess of brain amine neurotransmitters |
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Term
| Name three anti-mania medications. |
|
Definition
-Lithium carbonate
-Carbamazepine
-Divalproex |
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Term
| What is the mechanism of action of Lithium? |
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Definition
| It decreases the release of norepinephrine and dopamine in the CNS. It is used for prevention rather than treatment of acute episodes. |
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Term
| Pharmacokinetics of Lithium (3) |
|
Definition
-Taken orally
-Half-life of 24-36 hours
-Not metabolized in the body |
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Term
| What are the ADRs of Lithium (5)? |
|
Definition
-GI irritation
-Risk of gestational malformations
-Hypothyroidism
-Renal damage
-OD (narrow TI) |
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Term
| What are the nursing implications when administering Lithium (10)? |
|
Definition
-Assess suicide risk
-Monitor vital signs
-Monitor weight
-Inform patient effects may take weeks
-Patient should take as ordered, even if feeling better
-Avoid OTCs
-Avoid alcohol
-Avoid driving if drowsy
-Keep away from children
-Be careful of drug interactions |
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