Psychopharmacology: Antidepressants

SHARE:

ANTI DEPRESSANTS
Drugs used to elevate mood and alleviate other symptoms associated with moderate to severe depression.
Classification
l . Tricyclics :  e.g. Imipramine, Desipramine, Amitriptyline
2. Tetracyclics : Amoxapine
3. Monoamine Oxidase Inhibitors : e.g. Tranylcypramine, Phenelzine
4. Selective Serotonin Reuptake Inhibitors(SSRIs) : e.g. Fluvoxamine.
5. Novel Antidepressants- e.g. Bupropion, Trazadone,Venlafaxine
 Action
·         Increase the catecholamine levels in the brain
·         TCAs blocking the reuptake of NE and 5-HT at the nerve terminals, thus increasing the NE and 5-HT levels at the receptor site
·         Mono amines are responsible for the degradation of catecholamines after reuptake; so MAOIs increase the NE and 5-HT levels at the receptor site  
·         SSRIs inhibits the reuptake of serotonin
Pharmacokinetics
·         Absorption -from GIT
·         Distribution -bound to plasma protein and    tissue protein
·         Metabolism -liver
·         Excretion -kidney
Indication
l) Depression:
2)Childhood Psychiatric Disorders: Enuresis, Separation anxiety disorder, Somnambulism, School phobia, Night terrors
3)Other Psychiatric Disorders: Panic attack, Generalized anxiety disorder, Agora phobia, Social phobia, OCD, Eating disorder, Borderline personality disorder, PTSD, Depersonalization syndrome
4) Medical disorders: Chronic pain, Migraine, Peptic ulcer disease
Contra indications
·         Hypersensitivity
·         Recovery phase from myocardial infarction
·         Elderly or debilitated with hepatic, renal, cardiac insufficiency
·         History of seizure disorder  
·         Pregnancy and lactation
Side effects
Autonomic side effects-
Dry mouth, blurred vision, dry eyes, constipation, urinary retention, cycloplegia, mydriasis, delirium, orthostatic hypotension
cardiac effects-
tachycardia, arrhythmias and hypotension. Amitriptyline is considered most cardiotoxic drug
 CNS effects
sedation, confusion, disorientation, anxiety, insomnia, ataxia, tremors, seizures
Hypertensive crisis with MAOIs-
palpitation, tightness in chest, stiff neck, throbbing and radiating head ache. High blood pressure with the elevation of heart rate is common.
Sexual side effects:
impotence, impaired ejaculation, anorgasmia 
Rare effects:
agranulocytosis,   jaunuice, Skin rashes, systemic vasculitis
Weight gain

Nurses responsibility
·         Clients on MAOI should be warned against danger of tyramine rich foods which  results in hypertensive crisis. They are beef liver, chicken liver, dried fish, over   ripped fruits, chocolates, wine, beer, coffee etc.
·         Report for unusual symptoms like occipital headache, nausea, vomiting, chest pain.
·         Instruct not to take medication without prescription
·         Caution the patient to change his position slowly to minimize orthostatic hypotension
·         Strictly monitor of vital signs, especially blood pressure


COMMENTS

Name

anaphysio,3,ASEPSIS AND INFECTION CONTROL,9,audio,1,biochemistry,2,blog,1,BSN Notes: Assessment in Psychiatry,6,BSN Notes: Burns,11,BSN Notes: Care of Terminally Ill Patients,6,BSN Notes: Childhood and Developmental Disorders,6,BSN Notes: Common Behavioural and Social Problems,4,BSN Notes: Common Childhood Diseases,7,BSN Notes: Common Signs And Symptoms,32,BSN Notes: Community Mental Health Nursing,12,BSN Notes: Critical Care,12,BSN Notes: Disaster and Emergency,15,BSN Notes: ENT,8,BSN Notes: Eye,25,BSN Notes: History and Assessment,24,BSN Notes: Introduction of Psychiatry,27,BSN Notes: Legal Issues In Psychiatry,4,BSN Notes: Medication Administration,24,BSN Notes: Neuritic_Stress related and Somatization Disorders,10,BSN Notes: Neurology,6,BSN Notes: Oncological Nursing,8,BSN Notes: Organic Brain Disorders,1,BSN Notes: Oxygenation,3,BSN Notes: Personality_Sexual and Eating Disorders,5,BSN Notes: Principles and Concepts of Psychiatry Nursing,2,BSN Notes: Psych-pharmacology and Other Treatment Modalities,30,BSN Notes: Psychiatry Emergencies and Crisis Intervention,4,BSN Notes: Psychosocial Needs,5,BSN Notes: Schizophrenia and othe Psychotic Disorders,4,BSN Notes: The healthy child,5,BSN Notes: TNPR,9,BSN Notes: Urinary Elimination,14,chn,41,clinicalkannada,4,clinicals1,35,clinicals2,10,clinicals3,26,clinicals4,11,Code of Ethics,3,community,7,Critical thinking,7,drugs,3,Equipment & Linen,9,Equipments & Linen,1,Etics and Legal,1,exa,1,exam,11,featured,19,fon,141,fon3,141,fun,1,geriatric,1,graphic,1,Growth and Development,5,he,93,hotspot,6,kannada,54,language,1,Machinery,10,Medications,1,Memory Tools,9,mhn,126,microbiology,3,misc,2,mnemonics,48,msn,137,NCLEX,13,ncp,27,news,4,obg,28,OBG Medications,1,Peri- operative Nursing,2,pharma,29,Physical Examination and Assessment,9,Psychology,2,Pulse,7,resources,1,Respiration,4,Transitional care,1,Ventilators,5,voice,2,
ltr
item
notes.nursium.com: Psychopharmacology: Antidepressants
Psychopharmacology: Antidepressants
notes.nursium.com
http://notes.nursium.com/2017/06/psychopharmacology-antidepressants.html
http://notes.nursium.com/
http://notes.nursium.com/
http://notes.nursium.com/2017/06/psychopharmacology-antidepressants.html
true
3454605208880343795
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy