Nursing 212

Health Differences Across the Lifespan 2 Study Guide

Antidepressants: used to treat chronic insomnia, attention deficit hyperactivity disorder, and panic disorder; therapeutic level occurs in 1-3 weeks, with maximum effect in 6-8 weeks Drug Class Generic (Trade) Name Nursing Responsibilities Tricyclic Antidepressants (TCAs) Amitriptyline (Elavil); Clomipramine (Anafranil); Desipramine (Norpramin); Doxepin (Sinequan); Imipramine (Tofranil); Nortriptyline (Pamelor); Protriptyline (Vivactil); Trimipramine (Surmontil) Inform patient that side effects diminish over time; warn about significant weight gain; advise that response will take time Second Generation Tetracyclines Amoxapine (Asendin); Maprotiline (Ludiomil); Mirtazepine (Remeron) General considerations are same as tricyclics SSRIs Citalopram (Celexa); Escitalopram (Lexapro); Fluoxetine (Prozac); Fluvoxamine (Luvox); Paroxetine (Paxil); Sertraline (Zoloft) Inform to take medication as prescribed; monitor for side effects, particularly in the area of sexual dysfunction; patient may be reluctant to discuss Monoamine Oxidase Inhibitors (MAOIs) Isocarboxazid (Marplan); Phenelzine (Nardil); Selegiline (Emsam); Tranylcypromine (Parnate) Educate about a tyramine restricted diet Atypical Antidepressants Amoxapine (Asendin); Bupropion (Wellbutrin); Desvenlafaxine (Pristiq); Duloxetine (Cymbalta); Mirtazapine (Remeron); Nefazodone (Serzone); Trazodone (Desyrel); Venlafaxine (Effexor) Instruct patient about importance of taking this medication as prescribed; instruct patient to report any signs of sexual dysfunction Common adverse effects from antidepressant medications: orthostatic hypotension, anticholinergic, sedation, cardiac toxicity, seizures, hypomania, sexual dysfunction, and hypertensive crisis from tyramine Foods to avoid with MAOIs: aged cheese, yogurt, sour cream, hot dogs, bologna, pepperoni, salami, sausage, raisins, canned figs, papaya, soybean extracts, draft beer, red wine, sauerkraut, soy sauce, yeast extracts, soups with protein extracts, Brewer’s yeast, other antidepressant drugs, nasal and sinus decongestants, allergy, hayfever and asthma remedies, Demerol, epinephrine, stimulants, cocaine andamphetamines

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