CNS Antidepressants Flashcards
(21 cards)
What is a Depressive Episode?
A person experiences a depressed mood or a loss of pleasure or interest in activities for most of the day, nearly every day, for at least 2 weeks.
How many symptoms are required for a Major Depressive Disorder diagnosis?
Five or more symptoms from DSM-5 during the same two-week period.
What is the action of Selective Serotonin Reuptake Inhibitors (SSRIs)?
Inhibits the reuptake of serotonin at nerve endings, prolonging serotonin activity.
This class of antidepressants includes medications like Citalopram, Fluoxetine, and Sertraline.
List three indications for SSRIs.
- Antidepressant
- Antianxiety
- Post traumatic stress disorder (PTSD)
SSRIs may also be used for eating disorders and migraines.
What is the action of Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)?
Inhibits the reuptake of serotonin and norepinephrine at nerve endings.
Venlafaxine (Effexor) is a common SNRI.
What are some indications for SNRIs?
- Depression
- Anxiety Disorders
- Chronic/Neuropathic Pain
SNRIs are particularly useful for pain management.
What are the symptoms of Neuroleptic Malignant Syndrome?
- High fever
- Confusion
- Rigid muscles
- Variable blood pressure
- Sweating
- Fast heart rate
- Incontinence
- Flushing
- Skin Pallor
This syndrome can occur as a severe reaction to antipsychotic medications.
What are key nursing considerations for patients on SSRIs/SNRIs?
- Assess mental status, mood, and changes in behavior or suicidal thoughts
- Assess for serotonin syndrome
- Assess appetite and nutritional intake
- Assess BP
- Assess for sexual dysfunction
- Taper dose if discontinuing
Benefits may take 2-4 weeks to notice, with full effects possibly taking up to 12 weeks.
What are common side effects of SSRIs/SNRIs?
- Suicidal thoughts
- Serotonin Syndrome
- Seizures
- Decreased libido
- Weight loss or weight gain
- Insomnia
- Orthostatic hypotension
Specific monitoring is required for blood pressure in patients on SNRIs.
What is Serotonin Syndrome?
- Change in LOC
- Agitation
- Hallucinations
- Delirium
- Coma
- Autonomic instability
- Tachycardia
- Labile BP
- Dizziness
- Diaphoresis
- Flushing
- Hyperthermia
- Neuro symptoms
- Tremor
- Rigidity
- Hyperreflexia
- Incoordination
- Seizures
What is the action of Tricyclic Antidepressants?
Block reuptake of neurotransmitters (serotonin and norepinephrine), causing accumulation at the nerve endings.
List three indications for Tricyclic Antidepressants.
- Antidepressant
- Neuropathic pain
- Insomnia
These medications are considered 1st generation antidepressants.
What are common side effects of Tricyclic Antidepressants?
- Suicidal thoughts
- Drowsiness
- Fatigue
- Sedation
- Anticholinergic effects
- Arrhythmias
- Weight gain
- Decreased libido
What are signs of Tricyclic Antidepressant toxicity?
- Arrhythmias
- Seizures
- Hallucinations
- Fever
What should be monitored when a patient is on Tricyclic Antidepressants?
- Mental status
- Mood changes
- Appetite
- Nutritional intake
- Weight
- BP and HR
Monitoring is crucial due to the risk of falls and cardiovascular issues.
What is the action of Monoamine Oxidase Inhibitors (MAOIs)?
Inhibit the MAO enzyme system in the CNS, leading to higher levels of amines like dopamine, serotonin, and norepinephrine.
MAOIs are typically reserved for patients who do not respond to other therapies.
List two common MAOIs.
- Tranylcypromine (Parnate)
- Phenelzine (Nardil)
MAOIs can have serious interactions with certain foods and medications.
What are side effects of MAOIs?
- Seizures
- Suicidal thoughts
- Dizziness
- Hypertensive crisis
- Nausea
- Weight changes
- Urinary retention
Patients must avoid tyramine-rich foods to prevent hypertensive crises.
What foods should be avoided with MAOIs?
- Alcoholic beverages
- Aged cheeses
- Processed meats
- Dried or overripe fruits
- Sauerkraut
These foods can lead to a hypertensive crisis when consumed with MAOIs.
What is a hypertensive crisis?
Extreme increase in blood pressure (greater than 180/120) with symptoms like occipital headache, neck stiffness, and palpitations.
This is a medical emergency requiring immediate intervention.
What treatment is required for a hypertensive crisis related to MAOIs?
- Hold MAOI
- Gastric lavage
- Administer hypotensive drugs
Prompt treatment is essential to prevent serious complications.
