Depression

Question 1

Tricyclic Antidepressants (TCAs)

Answer 1

Amitriptyline (Elavil)

Nortriptyline (Pamelor)

Question 2

Amitriptyline (Elavil)

Nortriptyline (Pamelor) is used

Answer 2

Mainstay for depression treatment

Question 3

MOA for Amitriptyline (Elavil)

Nortriptyline (Pamelor)

Answer 3

• Block reuptake of norepinephrine and serotonin into presynaptic nerve terminate
• Increase actions of both neurotransmitters
• Block Ach receptors

Question 4

Adverse effects of Amitriptyline (Elavil)

Nortriptyline (Pamelor)

Answer 4

• No known antidote for overdose

- Estimated 70% TCA overdoses died before reaching hospital

Question 5

Monoamine Oxidase Inhibitors (MAOIs)

Answer 5

Phenelzine (Nardil)

Question 6

Used for Phenelzine (Nardil)

Answer 6

Effective but seldom used due to serious adverse effects

Question 7

Phenelzine (Nardil) MOA

Answer 7

• Bind irreversibly to MAO

- Intensify actions of endogenous epinephrine, norepinephrine, serotonin, dopamine

Question 8

Phenelzine (Nardil) adverse effects

Answer 8

Orthostatic hypotension

Question 9

Nursing Concerns Phenelzine (Nardil)

Answer 9

Common drug and food interactions

Avoid food containing tyramine

Question 10

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 10

Fluoxetine (Prozac)

Question 11

Fluoxetine (Prozac) is used for

Answer 11

• Second generation antidepressant

- Effective and low incidence of serious side effects

Question 12

MOA of Fluoxetine (Prozac)

Answer 12

• Block uptake of serotonin at neuronal presynaptic membrane

- Enhance action of serotonin

Question 13

Adverse Effects Fluoxetine (Prozac)

Answer 13

• GI upset
• Anorexia
• Sexual dysfunction

Question 14

Nursing concerns for Fluoxetine (Prozac)

Answer 14

• Full therapeutic effects appear in 2-6 weeks

- Avoid food containing tyramine for interaction