General Info
What to observe for? What to monitor?
- Observe for mood changes, suicidal ideations
- Monitor VS and weight
3 Example Drugs?
- Tranylcypromine (Parnate)
- Phenelzine (Nardil)
- Isocarboxazid (Marplan)
- Selegiline
What foods to avoid on MAOI's? Examples?
Foods containing tyramine
- Chocolate, red wine, aged cheese, fava beans, Italian gree beans, yogurt, bananas, soy sauce, yeast, beer, liver, raisins, processed meats
What need to happens before starting another med?
Two week “wash out” is needed before beginning any other medication
- Prevents serotonin syndrome
2 Drug Examples? Main SE with NDRI's?
- Buproprion (Wellbutrin)
- Trazadone (Oleptra) - Serotonin Modulator
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
* MAIN SE IS 1) Wellbutrin = INSOMNIA 2) Trazodone = SEDATION *
Discuss what three things with the pt?
- Discuss side effects with patients
- Discuss pregnancy prevention
- Importance of pt's taking meds as prescribed
MAOI's are the __ and ___ antidepressant
First and oldest antidepressant
Why do you have to avoid these foods?
Eating any of these foods with tyramine can cause a HTN CRISIS!!!!!!
Avoid what 4 things?
CANO
- Calcium
- Antacids
- NSAIDS's like Acetaminophen
- OTC drugs
Bupropion (Wellbutrin): Uses? SE's?
Used for depression, seasonal affective disorder (SAD), smoking cessation
- SE: HA, insomnia, weight loss, lowers the seizure threshold, NO sexual dysfunction
Take a thorough ___
History
MAO type B: _____ – used for _____ Disease
Selegiline
Parkinson
Increased risk for what two things? First sign?
- Increased suicide risk: report feelings
- Risk for massive HTN crisis: first sign is severe HA
Bupropion (Wellbutrin): Do you have to wait for it to work?
Works right away! No waiting!
What four things to avoid?
- Alcohol
- CNS depressants
- Herbal supplements
- OTC medication
Do MAOI's have DRY or SLUDGE effect?
Anticholinergic effects (DRY)
Can you take MAOI's with other antidepressants?
Do NOT take with any other antidepressant
What is the big caution with NDRI's?
Caution: Lowers seizure threshold
* No alcohol and Use hard candy or gum for dry mouth *
What herb to avoid with antidepressants?
St. John’s Wort
MAOI's SE's?
CNS stimulation, Insomnia, and Orthostatic hypotension
Can you stop when you want to?
Avoid T___ and G____
Avoid Tyramine and Grapefruit juice
- Do NOT stop drug suddenly: slowly taper
Trazadone (Oleptra): Use? SE's?
Used for depression and insomnia
- SE: Sedation, hypotension, dry mouth, Serotonin Syndrome