Term
Unipolar depression symptoms |
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Definition
i. Feelings of intense sadness and despair, mental slowing and loss of concentration, pessimistic worry, lack of pleasure, self-deprecation, and variable agitation or hostility, decreased libido
ii. Insomnia or hypersomnia, altered eating patterns: anorexia and weight loss or overeating, decreased energy and libido, and disruption of the normal circadian and ultradian rhythms of activity, body temperature, and many endocrine functions
iii. Women are at 2x the risk as men
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Term
Antidepressant charcteristics |
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Definition
| orally administered, 90-95% bound to plasma proteins, metabolized by the liver, excreted in urine, long “half-lives” (e.g., imipramine - t½=24 hours), relatively small therapeutic index |
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Term
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Definition
1. Limit reuptake of serotonin and norepinephrine – leaves more in synapse to take effect.
2. Requires 2-3 weeks for clinical improvement
3. Anticholinergic side effects are common: blurred vision, dry mouth, constipation, urine retention.
4. Antagonist activity at alpha 1 receptors cause cardiac side effects such as tachycardia and orthostatic hypotension as well as CNS side effect of sedation |
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Term
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Definition
amitriptyline, clomipramine, doxepin, imipramine,trimipramine – slightly more serotonin effects |
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Term
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Definition
| usually given for OCD, enhances adrenergic neurotransmitter transmission through blocked reuptake at the synapse. |
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Term
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Definition
| Tertiary TCA with the absence of CV side effects |
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Term
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Definition
| TCA with anticholinergic properties: enuresis (bed wetting) in children over 6 |
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Term
Secondary amine tricyclics |
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Definition
| amoxapine, desipramine, maprotiline, nortryptyline, protryptyline – slightly more norepinephine effects |
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Term
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Definition
Blocks the reabsortion of NE and HT-5 (serotonin), which allows more neurotransmitters to be available at postsynaptic receptors
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Term
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Definition
Depression: alcohol and drug withdrawal, major depression
Bi-Polar disorder (manic-depressive)
Often used for clients who fail to respond well to antidepressants (SSRIs) |
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Term
Contraindications of TCAs |
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Definition
Acute recovery phase of myocardial ischemia or severe coronary artery disease
Do not administer within 14 days of taking MAOIs |
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Term
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Definition
| Sedation, anticholinergic effects (dry mouth,headache, urinary retention, blurred vision, tachycardia), orthostatic hypotension, seizures |
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Term
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Definition
| decreases the reuptake of HT-5 at selected nerve terminals in the CNS. they also have a weak effect on the reuptake of NE and dopamine. Increased availability of HT-5 at receptors results in mood elevation and reduced anxiety. |
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Term
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Definition
a. Increases sedation
b. Decreases appetite
c. Decreases libido and impairs sexual function
d. Increases mood |
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Term
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Definition
| nausea, insomnia, weight gain, sexual dysfunction (decreased libido, delayed ejac, delayed or absent orgasm (BOOO!!)), hyponatremia, neonatal withdrawal, increased risk of GI bleeding, Serotonin syndrome (agitation, confusion, disorientation, hallucinations) |
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Term
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Definition
| "Prozac”; t1/2=72 hr., 12-15 days to reach TE |
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Term
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Definition
| (“Paxil” – noted for its anticholinergic side effects; recently approved for social phobia) |
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Term
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Definition
a. citalopram (“Celexa”)
b. escitalopram (“Lexapro”)
c. fluoxetine (“Prozac”; t1/2=72 hr.) (12-15 days to reach TE)
d. fluvoxamine (“Luvox”)
e. paroxetine (“Paxil” – noted for its anticholinergic side effects; recently approved for social phobia)
f. sertraline (“Zoloft”; t1/2=36 hr.) |
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Term
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Definition
| In general, these have fewer antimuscarinic effects than the tricyclics and have a more potent adrenergic effect compared to their serotonergic effect. |
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Term
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Definition
duloxetine (“Cymbalta”)
Imilnacipran (“Ixel”)
venlafaxine (“Effexor”) |
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Term
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Definition
| The antidepressant effects of MAOIs are the result of blocking monoamine oxidase in the nerve terminals. This action increases the availability and concentrationof NE and HT-5 for neurotrasmission. |
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Term
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Definition
| MAOIs are reserved for depressed clients who have not responded to TCAs, SSRIs, SNRIs. Last measure before ECT |
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Term
Contraindications of MAOIs |
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Definition
Do not use in clients with impaired renal of hepatic function
Do not use in peeps with CAD, CHF, HTN
DO NOT USE WITH SSRIs
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Term
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Definition
| Hypertensive crisis can be triggered by eating foods rich in tyramine (precursor to NE) such as pickled, aged, caffinated or ferminted food or drinks and meds containing diuretics, antihistamines, antihypertensives, and ephedrine. |
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Term
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Definition
CNS stimulation (anxiety, agitation, hypomania, mania)
Orthostatic hypotension
hypertensive crisis from intake of tyramine-containing foods |
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Term
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Definition
a. isocarboxazid (“Marplan”)
b. phenelzine (“Nardil”)
c. tranylcypromine (“Parnate”) |
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Term
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Definition
1. Buproprion (“Wellbutrin” – lowers seizure threshold 3-fold*, free of sexual side effects), mirtazepine, reboxetine, trazadone. |
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Term
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Definition
A. Aspects of major (unipolar) depression that cycle with mania or hypomania |
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Term
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Definition
1. GI: nausea, diarrhea, drowsiness, polyuria, dry mouth, thirst, weight gain, insomnia
2. Thyroid enlargement – nontender, benign
Signs of acute lithium intoxication: vomiting, diarrhea, tremor, coma, convulsions |
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Term
Lithium and other drug interactions
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Definition
1. Interacts with diuretics, because these commonly increase sodium excretion, thereby decreasing lithium excretion, leading to buildup of toxic levels of lithium
2. increase excretion – osmotic diuretics and acetazolamide
decrease excretion – the thiazides and other diuretics that deplete sodium |
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