Antidepressants! (what I need after going to nursing 2) (MAOI, TCA, SSRI)

MAOIs

monoamine oxidase inhibitors

TCAs

tricyclic antidepressants

SSRIs

selective serotonin reuptake inhibitors

How do MAOIs work?

blocks breakdown of neurotransmitters (dopamine, serotonin, epi, norepi) aka "inhibiting monoamine oxidase"

it increases the amount of norepinephrine at the synaptic junction

how do TCAs work?

TCAs decrease the reabsorption of norepinephrine and serotonin.

how do SSRIs work?

They selectively inhibit serotonin reuptake into the presynaptic terminals. this increases the amount of serotonin at the nerve endings

Seratonin

A neurotransmitter that affects mood, hunger, sleep, and arousal

what are 4 generic names for MAOIs

isocarboxazid

tranyicypromine

phenelzine

moclobemide

what is the trade name for isocarboxazid

Marplan

what is the trade name for tranyicypromine

partite

what is the trade name for moclobemide

manerix

what is the trade name for phenelzine

Nardil

what are two generic names for TCAs

amitriptyline

doxepin

what is the brand name for amitriptyline

Elavil

what is the brand name for doxepin

Sinequan

SSRIs are considered

first line medications

what is a first line medication

the initial treatment

generic names of SSRIs include

Fluoxetine

Paroxetine

Sertraline

Citalopram

trade name of fluoxetine

Prozac

trade name of paroxetine

Paxil

trade name of sertraline

Zoloft

trade name of Citalopram

Celexa

what kind of patient needs TCAs?

patients with major depressive episodes and panic disorders

MAOIs are very effective

second line drugs

what is the main drawback of prescribing MAOIs

hypertensive crisis

SSRIs are best to help patients with

depression and major anxiety

who should not use MAOIs

patients with

-impaired renal and liver function

-CAD,CHF,HTN

_cerebrovascular defects

-pregnant or breastfeeding mothers

-pts eating foods containing tyramine and caffiene

Foods that contain tyramine

Aged, mature cheeses (cheddar, blue, Swiss)

Smoked/pickled or aged meats, fish, poultry

Yeast extracts

Red wines

Italian broad beans

what kinds of patients should not use TCA medication

patients with...

-severe CAD

-cardiac dysrhythmias

-hyperthyroidism

-benign prostate

-hypertrophy

-seizure disorder

what kinds of patients should not use SSRI medication

patients should not use this medicine

-if they are taking other antidepressants

-uncontrolled seizures

-bleeding

MAOI common adverse affects

weight gain

edema

sexual dysfunction

MAOI- life threatening side effects

orthostatic hypotension

if someone taking a MAOI medication eats food containing caffeine and tyramine, it can lead to

hypertensive crisis

common adverse effects for TCAs

dry mouth

urinary difficulty

constipation

burred vision

tremors

life threatening effects for TCAs

overdose

seizure

dysrhythmias with cardiac arrest

SSRIs are tolerated by

elderly people

SSRI common side effects

Agitation

insomnia

headache

nausea and vomiting

sexual dysfunction

hyponatremia

SSRIs have the least

side effects

MAOIs need to be monitored for

hypertensive crisis

MAOIs, TCAs, and SSRIs ALL can take up to ___________ to achieve therapeutic effect

up to 4 weeks

TCAs should be administered when

at bed time

TCAs and MAOIs patients need to change positions

SLOWLY

orthostatic hypotension

A patient taking TCAs should avoid

smoking

if someone taking TCA medicine has dry mouth, the nurse can recommend for them to

suck on candy

SSRIs should NOT be started ___________ of MAOIs

DO NOT START WITHIN TWO WEEKS

you should monitor for _____ and _______ for someone taking SSRIs

liver function

seizures

someone taking SSRIs should avoid ____

alcohol

herbs

OTC medications

DO NOT stop taking SSRIs abruptly or _______

s/s will occur

the antidote for TCAs are

sodium bicarbonate

the antidote for SSRIs are

cyproheptadine

the effective evaluation for all of these antidepressant medications is

lowered depression

lowered anxiety

the antidote for MAOIs

Phentolamine