Attention deficit/hyperactivity disorder (ADHD)
Disorder typically diagnosed in childhood and adolescence characterized by hyperactivity as well as attention, organization and behavioral control issues
Bipolar Diorder
Syndrome characterized by extreme and opposite moods, such as euphoria and depression
Depression
disorder characterized by a sad or despondent mood.
Dysthymic disorder
Less severe type of mood disorder that may prevent a person from feeling well or functioning normally
Electroconvulsive therapy (ECT)
Treatment used for serious and life-threatening mood disorders in patients who are unresponsive to pharmacotherapy
Major depressive disorder
A depressed mood lasting for a minimum of 2 weeks that is present for most of the day, every day, or almost every day
Mania
condition characterized by an expressive, impulsive, excitable, and overreactive nature
Monoamine oxidase inhibitor (MAOI)
Drug inhibiting monoamine oxidase, an enzme that terminate the actions of neurotransmitters such as dopamine, norepinephrine, epinephine and serotonin
Mood disorder
Change in behavior such as clinical depression, emotional swings, or manic depression
Mood stabilizer
Drug that levels mood that is used to treat bipolar disorder and mania
Postpartum depression
Occurring after childbirth
Psychotic depression
Expression of intensely negative mood shifts and unusual behaviors involving hallucinations, delusions, disorganized speech patterns, or loss of contact with reality
Seasonal affective disorder (SAD)
Type of depression experienced during the dark winter months
Selective serotonin reuptake inhibitor (SSRI)
Drug that selective inhibits the reuptake of serotonin into nerve terminals; used mostly for depression
Serotonin syndrome (SES)
Set of signs and symptoms associated with over medication with antiderpessants that includes altered mental status, fever, sweating and lack of muscular coordination
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Specifically inhibit the reabsorption of serotonin and norepinephrine and elevate mood by increasing the levels of these agents in the central nervous system
Tricyclic antidepressant (TCA)
Class of drugs used in the pharmacotherapy of depression
Tyramine
Form of the amino acid tyrosine that is found in foods such as cheese, beer, wine and yeast products
What are the approaches to treatment of major depression?
proper health examination, medications, psychotherpeutic techniques, electroconsulve or rTMS therapy.
How do antidepressants act?
by correcting neurotransmitter imbalances in the brain
What are the two basic mechanisms of antidepressants?
blocking the enzymatic breakdown of norepinephrine and slowing the reuptake of serotonin
What are the primary classes of antidepressants
TCAs, SSRIs,atypical and MAOIs
Why are tricylic antidepressants not used much?
unpleasant and serious side effects
How do SSRIs act?
by selectively blocking the reuptake of serotonin in nerve terminals
What drug is the choice in treatment of depression?
SSRIs
What is a serious concern with SSRIs?
serotonin syndrome
When are MAOIs prescribed?
in cases when other antidepressants have not been successul, they have more serious side effects than other antidepressants
What drugs are used to treat bipolar disorder?
Lithium, antiseizure drugs, adn atypical antipsychotic drugs
Antiseizure drugs are more effective in treating?
mania or for cycling and mixed states of bipolar
What are atypical antipsychotics more effective in treating?
acute mania, and longer-term psychotic depression
What are the most common drugs for symptoms of ADHD?
CNS stimulants such as Ritalin, newer nonstimulant drug is Strattera
Anticholinergic effects are common adverse effects of antidepressants such as imipramine (Tofranil) These effects may include
blurred vision, dry mouth and constipation
The parents of a patient receiving Ritalin express concern that the health care provider has suggested that the child have a holiday from the drug. The nurse explains that the drug free holiday is designed to:
decrease drug dependence and assess status
What signs would indicate a client is experiencing lithium toxicity?
Diarrhea, taxia, hypotension & edema, slurred speech and muscle weakness
A 17 year old male has started valproic acid (Depakene) for treatment of bipolar disorder. While he is taking the drug, he should be carefully monitored for:
An increased susceptibility to infections
What would be a priority componet of the teaching plan for a patient prescribed phenelzine( Nardil) for treatment of depression?
Read labels of food and over the counter drugs
A patient experienceing moderate depression is places on Zoloft. The nurse should counsel the patient to expect full effects from the drug in:
a month or longer
A type of mood disorder experiences by some patients during winter months is seasonal ____disorder.
effective
The two major types of mood disorders are _____ and _____ _______.
depression, bipolar disorder
The three major classes of antidepressants are?
tricyclic antidepressants (TCA)
selective serotonin reuptake inhibitor (SSRI)
monoamine oxidase inhibitor (MAOI)
____ are drugs of choice for depression.
SSRIs
___ produce fewer cardiovascular side effects and therefore are less dangerous than the MAOIs
TCAs
Patients taking____ for bipolar disorder should not be placed on a low-sodium diet.
lithium
The inability to focus or pay attention is one of the major symptoms of ______.
attention deficit/hyperactivity disorder ADHD
____ is the class of drugs most widely prescribed for ADHD.
CNS stimulates
Drugs for bipolar disorders are called _____ _______ because they have the ability to modulate extreme shifts in emotions between ____ and _____.
mood stabilizers, mania, depression
lithium carbonate (Eskalith) primary indication
bipolar disorder
venlafaxine (Effexor) primary indication
depression/atypical/SNRI
paroxetine (Paxil) primary indication
depression/SSRI
amitriptyline hydrochloride (Elavil) primary indication
depression/tricyclic type
phenelzine sulfate (Nardil) primary indication
depression/MAOI
methylphenidate hydrochloride (Ritalin) primary indication
ADD/CNS stimulant
lisdexamfetamine (Vyvanse) primary indication
ADD/CNS stimulant
tranylcypromine sulfate (Parnate)
depression/MAOI
nortriptyline hycrochloride (Pamelor)
depression/tricyclic type
bupropion hydrochloride (Wellbutrin)
bipolar disorder
fluoxetine hydrochloride (Prozac)
depression/SSRI
sertraline hycrochloride (Zoloft)
depression/SSRI
An enzyme that breaks down catecholamine neurotransmitters in the synapse?
monoamine oxidase
Accumulation of serotonin when taking two drugs that reduce serotonin uptake
serotonin syndrome
Condition exhibiting signs of both clinical derpession and mania.
bipolar disorder
The class of drug that is closely related to methlyphenidate
amphetiamines
Chemical found in medication that cannot be ingested by patients on MAOIs because of high risk of severe hypertension
tyramine
What is the most common age range for the diagnosis of attention-deficit disorder (ADD)?
3 to 7 years
What medication has not been useful in stabilizing emotions in mood disorders such as bipolar disorder?
Pemoline (Cylert)
Lithium is used with other medication during phases of bipolar disorder. The nurse knows that this medication would not be used with lithium.
Diuretics
Which of the following is an advantage of using atomoxetine hydrochloride (Strattera) instead of a scheduled CNS stimulant?
Strattera improves ability to focus and decreases hyperactivity.
A patient is sent home after being given fluoxetine (Prozac) for depression. The nurse should instruct the patient to do which of the following?
Expect to see improvement in mood, appetite, and energy within 1 to 3 weeks.
Methylphenidate (Ritalin) produces its effects by activating what portion of the brain?
Reticular activating system
When sending a patient home on imipramine (Tofranil), what is important for the nurse to teach patients?
This drug should not be stopped abruptly
In assessing a patient, the nurse should know that rapid shifts in emotions from profound depression to euphoria and hyperactivity are characteristic of what?
Bipolar disorder
What drug would be least likely to treat clinical depression?
Phenothizaines
How does phenelzine (Nardil) produces its therapeutic effects?
Irreversibly inhivits monoamine oxidase (MAO) and intensifies the effects of norepinephrine in the synapse
How do tricylic antidepressants produce their therapeutic effects?
Inhibit the reuptake of both serotonin and norepinephrine into presynaptic nerve terminals
How does fluoxetine (Prozac) produce its therapeutic effects?
Selectively inhibits the reuptake of serotonin into presynaptic nerve terminals
Why are the selective serotonin reuptake inhibitors (SSRIs) generally preferred over classes of other antidepressants?
Produce fewer sympathomimetic and anticholinergic side effects
Because fluoxetine is a chemical precursor for serotonin synthesis, the nurse should teach patients taking fluoxetine to avoid foods high in which amino acid?
Try