Study Guide 3

Question 1

What are some of the major symptoms that can occur with SSRIs?

Answer 1

• tremors
• anxiety
• orthostatic hypotension
• serotonin syndrome

Question 2

In addition to SSRIs, what other drugs may cause serotonin syndrome?

Answer 2

SNRIs

Question 3

What causes serotonin syndrome?

Answer 3

Too much serotonin in brain tissue

Question 4

What are the s/s of serotonin syndrome?

Answer 4

• sweating
• restlessness
• agitation
• tachycardia
• NM hyperexcitability

Question 5

What do we mean by NM hyperexcitability?

Answer 5

• clonus
• tremor
• fasciculation
• rigidity

Question 6

Dangers of serotonin syndrome

Answer 6

• DEADLY

- danger of seizures

Question 7

When might a pt get serotonin syndrome?

Answer 7

• high doses of drugs

- 2 or more antidepressants at once

Question 8

Serotonin syndrome: reversible?

Answer 8

Yes - if drugs are withdrawn

Question 9

What are some of the major side effects of MAOIs?

Answer 9

• CNS excitation
• agitation
• irritability
• sleeplessness
• central/peripheral anticholinergic effects
• increased BP
• interactions

Question 10

What are the Central/Peripheral anticholinergic effects seen with MAOIs?

Answer 10

• tremor
• dry mouth
• urinary retention

Question 11

What can MAOIs have adverse interactions with?

Answer 11

• food
• caffeine/stimulants
• LOTS OF OTHER DRUGS

Question 12

Drugs that cause the most problems with MAOIs

Answer 12

• alcohol
• sleepy meds
• other antidepressants

Question 13

What foods do MAOIs interact with negatively?

Answer 13

fermented cheese/wine

Question 14

How do MAOIs interact with fermented cheese/wine?

Answer 14

• increase catecholamines

- cause MI/stroke

Question 15

Major adverse rxns associated with lithium

Answer 15

• seizures
• coma
• death
• sedation, muscle weakness, lethargy

Question 16

Sedation, lethargy, muscle weakness seen with lithium is also seen with a this drug class

Answer 16

Tricyclics

Question 17

What should a pt on the neuro drugs never do?

Answer 17

Never stop taking them abruptly

Question 18

Why must these drugs never be stopped abruptly?

Answer 18

• alter biochemistry

- may cause adverse effects

Question 19

Special considerations for these neuro drugs with rehab

Answer 19

• get list of ALL meds
• pt will gradually reach therapeutic level
• therapy timing

Question 20

Rehab considerations: list of meds

Answer 20

• Rx and OTC

- note any changes or additions

Question 21

Rehab considerations: time to reach therapeutic level

Answer 21

This will be reached within 2-4 weeks

Question 22

Rehab considerations: therapy timing

Answer 22

• shouldn’t matter if pt is at therapeutic level

- watch for orthostatic hypotension with tricyclics and lithium, especially in early stages and with the elderly