Anti-depressants

Question 1

primary treatment for depression

Answer 1

antidepressants

Question 2

5 classes of medication that treat depression

Answer 2

Selective serotonin reuptake inhibitors (SSRI’s)
Serotonin/norepinephrine reuptake inhibitors (SNRI’s)
Tricyclic antidepressants (TCA’s)
Monoamine oxidase inhibitors (MAOI’s)
Atypical antidepressants

Question 3

how long does it take to see benefits of pharmacotherapy for depression

Answer 3

1-3 weeks, can take up to 12 weeks for a response

Question 4

how long will pt. remain on med once in remission

Answer 4

4-9 months

Question 5

best practice for prescribing antidepressants

Answer 5

start low and go slow

Question 6

when discontinuing anti-depressant be sure to

Answer 6

taper or else pt. will get very sick

Question 7

all antidepressants come with a black box warning, t or f

Answer 7

true - suicide risk

Question 8

age related risks for suicide

Answer 8

18-24 increased risk for suicide
25-30 neutral effect
>30 decreased risk

Question 9

most commonly prescribed anti-depressant

Answer 9

SSRI

Question 10

prototype SSRI

Answer 10

Prozac

Question 11

Prozac is commonly prescribed for these disorders

Answer 11

OCD, Bulimia, Premenstrual Dysphoric Disorder

Question 12

SSRI adverse effects are considered low but include

Answer 12

weight gain and sexual dysfunction

Question 13

prototype SNRI

Answer 13

Effexor

Question 14

first line treatment for depression is an

Answer 14

SSRI

Question 15

which drug class has fewer adverse effects SSRI or SNRI

Answer 15

SSRI

Question 16

Effexor is commonly prescribed for these disorders

Answer 16

GAD - generalized anxiety disorder
major depression
social anxiety disorder

Question 17

how does Effexor work

Answer 17

blocks uptake of norepinephrine and serotonin

Question 18

s/e of Effexor

Answer 18

diastolic HTN - if known hx of HTN do not prescribe

Question 19

a serious reaction can occur with Effexor and MAOI’s, t or f

Answer 19

true - must wait 2 weeks in between the 2 meds

Question 20

tricyclic antidepressants are cardio toxic, t or f

Answer 20

true

Question 21

s/e of tricyclic antidepressants

Answer 21

dizziness (get up slowly),drowsiness, photophobia, blurred vision, dry eye, constipation, increased risk for seizures, hypomania, yawngasm, cardiotoxic

Question 22

tricyclic antidepressants are a good drug choice for these disorders

Answer 22

bipolar disorder and neuropathic pain

Question 23

composition of tricyclic antidepressants is similar to

Answer 23

phenothiazine’s

Question 24

how do tricyclic antidepressants work

Answer 24

blocks receptors for histamine and acetylcholine as well as serotonin and NE

Question 25

how often/when do you give tricyclic antidepressants

Answer 25

once a day at bedtime

Question 26

overdose with tricyclic antidepressants can be life threatening, t or f

Answer 26

true

Question 27

s/s of tricyclic antidepressant overdose

Answer 27

tachycardia and palpitations

Question 28

trt for tricyclic antidepressant overdose

Answer 28

charcoal with gastric lavage | propranolol

Question 29

*monoamine oxidase inhibitors and tyramine foods could cause this

Answer 29

hypertensive crisis

Question 30

how do monoamine oxidase inhibitors work

Answer 30

inactivates NE, serotonin and dopamine, increases neurotransmitters so pt. isn't depressed

Question 31

what type of foods have tyramine in them

Answer 31

processed foods aged cheese Swiss, bleu, pepperoni, salami

Question 32

drug of choice for atypical depression

Answer 32

monoamine oxidase inhibitors

Question 33

s/e of MOAI

Answer 33

HTN, headache, tachy, n/v, confusion, sweating

Question 34

atypical antidepressant

Answer 34

Wellbutrin

Question 35

moa of Wellbutrin

Answer 35

stimulates appetite w/o weight gain; increases sex drive/pleasure

Question 36

what type of disorder is contraindicated w/Wellbutrin

Answer 36

eating disorders - likely to develop a seizure

Question 37

non-conventional drugs found to treat depression

Answer 37

ketamine - bolus IV St. johns wort - interacts w/SSRI's SAMe

Question 38

MOA of SSRI (Prozac)

Answer 38

selective inhibition of serotonin uptake | CNS excitation