When ADRS begin when antidepressant meds are taken
- right away
Primary NT that are enhanced by antidepressant meds
- serotonin & norepinephrine
How often antidepressant meds are taken
Should be continued for 6-9 month after symptoms subside
When antidepressant meds start working
2-4 weeks
How antidepressant meds should be discontinued
- taper to discontinue
- don’t stop abruptly
Protype of the SSRI meds
Fluoxetine (Prozac)
MOA of Burpropion
- blocks reuptake of dopamine & norepinephrine
- inhibits nicotinic acetylcholine receptors
3 uses of Burpropion
- depression
- seasonal depression
- smoking cessation
- adult ADHD
ADRS of Burpropion
- headache
- decreased appetite
- weight loss
- restlessness
- tremor
- insomnia
- decreased seizure threshold
ADRS of tricyclic antidepressants (TCA’s)
- cardiac dysrhythmias
- heart block
- sedation
- anticholinergic effects
- ortho hypotension
- increased appetite
- excessive sweating
- decreased seizure threshold
How often and when tricyclics antidepressants should be taken
once a day at night since it causes sedation
MOA of tricyclic antidepressants
- block reuptake of serotonin & norepinephrine (dual action)
Prototype of MAO-I meds
Phenelzine (Nardil)
Common ADR reactions of MAO-Is
- anxiety
- agitation
- ortho hypotension
- drowsiness
- anticholinergic effects
Food interactions with MAO-Is
- avoid foods high in Tyramine
- avoid aged cheese
- avoid pickled & smoked fish
- wine
- beer
- avoid fermented foods
- avoid smoked & cured meats
- avoid overripe fruits
Drug interactions with St. Johns Wort
- antidepressants
- buspirone
- meperedine
S&S of serotonin syndrome
- tremors
- muscle rigidity
- mental changes
- increased HR, BP & temp
Common symptoms of HTN crisis
- sudden increased BP & HR
- nausea & vomiting
- headache - often occipital
- diaphoresis
- decreased LOC
Nursing interventions for HTN crisis
- early identification of S&S
- stop medication
- don’t lie flat
TI range of lithium
0.8-1.4 mEq/L
Appropiate fluid intake for lithium
1 & a half liters a day
How often patients should get lithium level when its first started
Initially every 2-3 days & then every 3-6 months
Meds to avoid when taking lithium
- Ibuprofen
- NSAIDS
- Diuretics
take Tylenol or ASA instead
Side Effects of Lithium
- GI distress
- fine hand tremor
- polyuria, thirst
- weight, gain
- bradydysrhythmias
- hypotension
- electrolyte imbalances
- fatigue, lethargy, headache, mental dullness
- renal effects
- hypothyroidism w/ long term tx
