Study Guide 3 Flashcards
(22 cards)
What are some of the major symptoms that can occur with SSRIs?
- tremors
- anxiety
- orthostatic hypotension
- serotonin syndrome
In addition to SSRIs, what other drugs may cause serotonin syndrome?
SNRIs
What causes serotonin syndrome?
Too much serotonin in brain tissue
What are the s/s of serotonin syndrome?
- sweating
- restlessness
- agitation
- tachycardia
- NM hyperexcitability
What do we mean by NM hyperexcitability?
- clonus
- tremor
- fasciculation
- rigidity
Dangers of serotonin syndrome
- DEADLY
- danger of seizures
When might a pt get serotonin syndrome?
- high doses of drugs
- 2 or more antidepressants at once
Serotonin syndrome: reversible?
Yes - if drugs are withdrawn
What are some of the major side effects of MAOIs?
- CNS excitation
- agitation
- irritability
- sleeplessness
- central/peripheral anticholinergic effects
- increased BP
- interactions
What are the Central/Peripheral anticholinergic effects seen with MAOIs?
- tremor
- dry mouth
- urinary retention
What can MAOIs have adverse interactions with?
- food
- caffeine/stimulants
- LOTS OF OTHER DRUGS
Drugs that cause the most problems with MAOIs
- alcohol
- sleepy meds
- other antidepressants
What foods do MAOIs interact with negatively?
fermented cheese/wine
How do MAOIs interact with fermented cheese/wine?
- increase catecholamines
- cause MI/stroke
Major adverse rxns associated with lithium
- seizures
- coma
- death
- sedation, muscle weakness, lethargy
Sedation, lethargy, muscle weakness seen with lithium is also seen with a this drug class
Tricyclics
What should a pt on the neuro drugs never do?
Never stop taking them abruptly
Why must these drugs never be stopped abruptly?
- alter biochemistry
- may cause adverse effects
Special considerations for these neuro drugs with rehab
- get list of ALL meds
- pt will gradually reach therapeutic level
- therapy timing
Rehab considerations: list of meds
- Rx and OTC
- note any changes or additions
Rehab considerations: time to reach therapeutic level
This will be reached within 2-4 weeks
Rehab considerations: therapy timing
- 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
