Depression
True or false: nursing school can make you depressed
FALSE, WE LOVE IT
This is the prototype MAOI
What is phenelzine?
This is the prototype TCA
What is imipramine?
These are the three most prescribed SSRIs
What are fluoxetine, citalopram, and sertraline?
This is another class of antidepressants that decreases the reuptake of serotonin and norepinephrine with little effect on dopamine
What are SNRIs?
This is the goal of drug therapy when treating depression
What is regulate neurotransmitter levels in the brain?
True or false: MAOIs are a last resort choice for the treatment of depression
TRUE-Why?
What is the black box warning for TCAs?
Increased risk of SI in children, adolescents, and young adults
List three indications for SSRIs
Depression, OCD, anxiety, bulimia, PMDD, PTSD, social phobias
This drug is effective for smoking cessation
What is buproprion (Wellbutrin)?
List four symptoms of depression
Irritability, weight loss/gain, social withdrawal, not taking care of self, lack of performance at work/school, fatigue, sleep disturbances, suicidal ideation, substance abuse/dependence
What dietary modifications do patients taking an MAOI need to adhere to and why?
No tyramine (aged cheeses and meats, red wine, fish, banana peel) because it can cause a hypertensive crisis
List three adverse effects of TCAs
Sedation, sleep disturbances, fatigue, hallucinations, ataxia, dry mouth, constipation, N/V
True or false: if an SSRI doesn't work, the patient can be immediately switched to an MAOI
FALSE-allow at least 6 weeks in between drugs
True or false: antidepressants work immediately and can be stopped abruptly at any time
FALSE-onset takes 4-6 weeks and drug must be tapered off
It is believed that depression is caused by deficiencies in these neurotransmitters
What is serotonin, norepinephrine, and dopamine?
List four adverse effects of MAOIs
Dizziness, mania, hyperreflexia, tremors, confusion, insomnia, agitation, liver toxicity, N/V, anorexia, weight gain, dry mouth, abdominal pain
This is the mode of action for TCAs
What is reduce the reuptake of 5HT (serotonin and dopamine) and norepinephrine in the nerves?
A person taking fluoxetine and experiencing fever, agitation, increased reflexes, tremor, and sweating is suffering from which condition?
List some patient education points for antidepressants
Increased risk of SI so patient must report if it occurs, use barrier contraceptives, do not mix MAOIs with any other antidepressant (or anything, really), avoid caffeine, practice good sleep habits
Describe the differences between affect, affective disorder, and depression
Affect: describes how a person presents a mood
Affective disorder: mood goes beyond ups and downs
Depression: feelings of sadness, despair, and hopelessness with physical manifestations
What is MAO and how do MAOIs affect it?
Monoamine oxidase is an enzyme that breaks down and inactivates neurotransmitters; MAOIs stop this process so the neurotransmitters can be used by the brain
True or false: tricyclic antidepressants get their name from the three cycles of depression.
False-the chemical structure of the drugs forms three rings, hence "tricyclic"
This herbal supplement interacts with SSRIs to greatly increase the risk of serotonin syndrome
What is St. John's Wort?
True or false: it is okay to need an antidepressant to survive nursing school
TRUE