Term
| GAD occurs for __ mo. or longer |
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Definition
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Term
| Which category of antidepressants have 'ugly' side effects? |
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Definition
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Term
| Major depressive disorder is a depressed mood lasting for a minimum of __ wks. and is out of ___ to life events. |
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Definition
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Term
| Imipramine/Tofranil (Ticyclic) is contraindicated in ___. |
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Definition
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Term
| Important adverse effects concerning IMipramine/Tofranil are..? |
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Definition
HypoTN
Anticholingergic SE
Tachycardia
Sedation
Lowers seizure threshold |
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Term
| What is an important adverse effect about the SNRI Effexor? |
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Definition
Black box warning: HRF suicide in children/adolescents
EffeXor
Black boX |
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Term
| The MAOI Nardil can cause ___ crisis. When used with ___ or ___, it can cause Serotonin syndrome |
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Definition
Hypertensive crisis
SSRIs or Lithium |
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Term
Lithium is preg. category __.
High levels of __ decrease Lithium's effects.
It takes __-__ weeks for full effect |
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Definition
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Term
Lithium therapeutic range: __-__ meq/L; toxic at __ meq/L.
S/S Mild toxicity:
S/S Severe toxicity: |
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Definition
0.5-1.5 meq/L; Toxic at 2 meq/L
CNS effect (tremor, ataxia)
Dysrhythmias, circulatory collapse |
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Term
Suicidal ideation
Poor energy
Sleep disturbance
Abnormal eating
Despair/guilt/hopeless
These are s/s of? |
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Definition
| Major Depressive Disorder |
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Term
| What is the most important assessment nurse needs on depressed client and their meds? |
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Definition
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Term
| What other meds can mimic s/s of depression? |
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Definition
Glucorticoids
Levodopa
Oral contraceptives |
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Term
| What limbic system neurotransmitters are depleted in a depressed client? |
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Definition
Dopamine
Serotonin
Norepinephrine |
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Term
Name the drug classes that help:
Norepinephrine (3)
Serotonin (2) |
|
Definition
1. SNRI
2. MAOI
3. TCA
1. SSRI
2. TCA |
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Term
| Name the tricyclic antidepressants. (Hint: 2 types of endings) |
|
Definition
Amitriptyline (Elavil)
Nortriptyline (Aventyl, Pamelor)
Protriptyline (Vivactil)
Clomipramine (Anafranil)
Doxepin (Sinequan)
Trimipramine (Surmontil)
Imipramine (Tofranil) |
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Term
Why to TCAs cause anticholinergic SE?
They block ___ receptors so it can't have its action. |
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Definition
| Ach- usually blocks off Norepinephrine |
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Term
| Name some anticholinergic side effects from TCAs. |
|
Definition
Constipation
Dry mouth
HTN
Sedation
Ortho hypoTN
Increased HR |
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Term
| Fact: Suicide potential increases as depressed patients feel better. |
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Definition
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Term
| What 4 things increase sedation with TCAs? |
|
Definition
ETOH
Barbs
Benzos
CNS depressants |
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Term
| What 3 things decrease TCA's effects? |
|
Definition
Oral contraceptives
Clonidine
Carbamazepine |
|
|
Term
How would you respond to these TCA side effects?
1. Ortho hypoTN
2. Anticholinergic SE
3. Increased HR
4. Increased RR
5. Increased BP
6. Constipation |
|
Definition
1. Ortho hypoTN: Change position slowly
2. Anticholinergic SE: Hard candy
3. Increased HR: Monitor
4. Increased RR: Monitor
5. Increased BP: Too minor
6. Constipation: Stool softener, fluids, fiber |
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Term
| Considering TCA side effects, why are they bad for post-MI or dysrhythmias? |
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Definition
| They cause tachycardia (increased O2 demand) |
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Term
| What is the MAJOR contraindication for SSRI/SNRIs? |
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Definition
|
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Term
| S/S serotonin syndrome (MAOI+SSRI/SNRI) |
|
Definition
H.A.R.M.
Hyperthermia
Autonomic instability (Delirium)
Rigidity
Myoclonus |
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|
Term
|
Definition
|
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Term
| SSRI/SNRI + ASA/Coumadin/NSAIDs = ? |
|
Definition
| HRF bleed; low HH, high PT/PTT |
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Term
| Why would we have problems with SSRI/SNRI compliance? |
|
Definition
| SE (Weight gain, sex dysfunction, seizures) |
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Term
| Name 3 MAOIs discussed in class. |
|
Definition
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|
Term
What foods could cause HTN crisis (MAOIs)?
What is the problem within the food? |
|
Definition
Aged (Beer, wine, cheese), turkey, organ meats
Tyramine |
|
|
Term
|
Definition
VERY high BP/palpitations
Nausea
HA, stiff neck
Flush/diaphoresis |
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|
Term
Why is Na depletion contraindicated w/ Lithium?
Lithium acts like __ in the body. If __ is depleted, Lithium will replace it within the cell (Causing Li toxocity) |
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Definition
|
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Term
What diseases could change Na Levels?
Increase Na (Li ineffective)
Decrease Na (Li toxic) |
|
Definition
Increased Na: CV diseases, Renal, DI, dehydration
Decreased Na: SIADH (Dilutional hyponatremia) |
|
|
Term
Sodium levels: ___-___
Hypernatremia v hyponatremia? |
|
Definition
Na 135-145
Hyper: Low UOP, spont muscle weak
Hypo: H/A, N/V/D, diminished DTR |
|
|
Term
Do these increase or decrease Lithium's effects?
1. Diuretics
2. NSAIDs
3. Thiazide diuretics
4. Theophylline
5. Iodine/Antithyroid
6. Haloperidol |
|
Definition
1. Diuretics: Increase
2. NSAIDs: Increase
3. Thiazide diuretics: Increase
4. Theophylline: Decrease
5. Iodine/Antithyroid: Decrease
6. Haloperidol: Increase |
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Term
| Why are labs for Li so frequent at the beginning or when a dose is changed? |
|
Definition
| Labs for 2-3 weeks bc the range is so narrow (0.5-1.5) |
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|
Term
| How do we know if Lithium levels are too low? |
|
Definition
|
|
Term
| S/S of Neuroleptic Malignant Syndrome |
|
Definition
F.E.V.E.R.
Fever
Encephalopathy
Vitals unstable
Elevated enzymes
Rigid muscles |
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