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Depression
on 141 final pg 1165
| Question | Answer |
|---|---|
| what is it often mistaken with | sadness |
| what is it | a disease that consists of one or more depressive episodes, depressed mood, diminished interest in activites,wt loss or gain, insomnia or hypersomnia, increased or decreased actiivty, fatigue, diminished ability to think, recurrent thoughts of death |
| cause | many causes (genetics, psychologicval, and physiological) |
| what other disorders ferquently occur with depression | schizophrenia, substance abuse, eating disorders, anxiety disorders, |
| after puberty who is more likely to have it (male or female) | female, twice as much |
| do most people have a single episode or repeated ones throughout their lifetime | repeated |
| risk factors | previous episode, female gender, family hx, stressful events, substance abuse, postpartum, hx of suicide attempts, chronic general med condition |
| depression causes loss of _________ | function |
| since there is a stigma associated with mental illnes ppl are less likely to do what | get help |
| goals of tx of depression | to decrease depressive s/s, improve pt functional level, prevent recurrance, |
| what are the four types of tx available | meds, psychotherapy, electroconvulsive therapy, light therapy |
| meds: what are the four classes of meds | tricyclics, SSRIs, SNRIs, MAOIs, |
| meds: what one is the first generation | tricyclics |
| meds: tricyclics-adverse effects | drowsiness, decreased BP, sun sensitive, numerous drug to drug interactions, |
| meds: tricyclics- names | amitriptyline (elavil), doxepin (adapin, sinequan) |
| meds: SSRis- what does that stand for | selective serotonin reuptake inhibitor; it increases the amount of neurotransmitter serotonin, w/o activating other neurotransmitters (,like norepinepthrine) |
| meds: tricyclics- action | increases norepinephrine and serotonin activity, tCA blocks the reuptake of serotonin and norepinephrine, increases the amoutns of these in the synapse |
| meds: what one is not used often anymore, butif pt was on it for years they are kept on it and not taken off | tricyclics |
| meds: SSRIs- adverse effects | dizziness, HA, insomnia, NO hypotension |
| what med does not have the adverse effect of hypotension | SSRIs |
| meds: SSRIs- names | fluoxetine (prozac), sertraline (zoloft), paraxetine (paxil), citalopram (celexa), escitalopram oxalate (lexapro), fluvoxamine (Luvox) |
| meds: SNRIs- what does it stand for; action | serotonin and norepinephrine reuptake inhibitors (SNRIs); they increase the levels of both serotonin and norepinephrine by inhibiting their reabsorbtion into cells in teh brain (to keep them working longer) |
| meds: SSRIs- is it given in high or low dosages | low |
| meds: SNRIs- names | wellbutrin, cymbalta, serzone, pristiq, remenron, effexor, desyrel |
| meds: MAOIs- what does it stand for | monamine oxidase inhibitors |
| meds: MAOIs- action | the effect thought to increase the avail. stores of serotonin,norepinephrine and dopamine by blocking monamine oxide(a protein that eats up these 3)and since depression is associated with low neurotransmitters increasing them will help alleviate s/s |
| meds: MAOIs- why is it not the first choice of drug | due to adverse reaction |
| meds: MAOIs- what is tyramine; why is it an issue when taking these meds | it is an amino acid that is a byproduct of the breakdown of proteins found in foods; it builds up in body and affect BP causing severe HTN, cerebral hemmorage, death |
| meds: MAOIs- what foods to avaoid | ages cheese, meath, fish, poultry, eggs, anything drief, smoked pickled, pepporoni, salami, bananas raisins, chocolate, benas, pickles olives, soy, nuts, ETOH |
| meds: MAOIs- names | parnate and nardil |
| meds: MAOIs- what adverse reaction could they go into | HTN crisis |
| how is it Dx | s/s are present daily for 2 weeks or more |
| Tx: how long is med tx treated with 1 episode; 2nd, 3rd? | 9 months with 1st, 5 years with 2nd, life for 3rd |
| why is self care an issue | pt is so depressed that they can't get out of bed to care for themselves |
| why is risk for injury an issue | when pt is on meds they may have enough energy to actually do something (ie suicide) |
| meds: tricyclics- when were they the first choice of meds | back in the 1950s |
| meds: tricyclics- how long does it take until they work | 2-4 weeks |
| meds: tricyclics- why should position changes be made slowly | bc/ hypotension side effect |
| meds: tricyclics- what is the anticholinergic side effect (s/s) | dry mouth, increased HR, hypotension, constipation, pupil dilation, blurred near vision, dry eyes, phtophobia |
| meds: what ones are usually the first choice of tx | SSRis or SNRis |
| meds: what ones can have bad adverse effects | tricyclics and MAOIs |
| meds: SSRIS- what herb should not be taken with it | st johns wart |
| meds: SSRIs- adverse effect of serotonin syndrome s/s; cause | change in LOC, agitation, muscle spasms, diaphorasis, shivering, tremor, diarrhea, abdominal cramps, HA; excessive amount s of serotonin activity |
| meds: SNRIs- adverse efefct and similar to what other class | SSRIs |
| meds: MAOIs- when to advise the pt to call MD | when pounding HA, pounding Ht, and stiff neck |
| meds: tricyclics and maois - if switching from one to the other how long should the relaspe between giving the two pills be | 14 days |
| meds: MAOIS- what is the first s/s of a hypertensive crisis | HA followed by a stiff and sore neck, N/V, sweatting fever |
| meds: why is there a disturbed sleep pattern | r/t solomnance |
Created by:
jmkettel
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