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Wellbutrin
- hereterocyclies
- he said to be considered as ssri
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pristiq
- snri
- he said to be considered as ssri
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Blurred vision
constipation
urinary retention
orthostatic hypotension
reduction of seziure threshold
tachycardia
arrhythmias
photosensitivity
weight gain
All are most common in what groups?
Tricyclics and heterocyclics
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Insomnia
agitation
headache
weight loss
sexual dysfunction
serotonin syndrome
Are most common in what groups?
SSRIs and SNRIs
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Side effect most common with MAOIs
Hypertensive crisis
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What should you tell patient with blurred vision from tricyclics and heterocyclics
- Clears in 1-2 weeks\
- dont drive
- clear walkways
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What should you know with reduction of seizure threshold for tricyclics and heterocyclics
- Observe patients with history closely
- Wellbutrin should be administerd in doses of no more than 150mg and should be given at least 4 hours apart.
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What should you tell patients about weight changes in patients on tricyclics and heterocyclics ?
- Weight gain
- provide instructions for reduced- calorie diet
- increased physical activity if appropriate
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Symptoms for serotonin syndrome
- changes in mental status
- reslessness
- myoclonus
- hyperreflexia
- tachcardia
- labile bp
- diaphoresis
- shivering
- tremors
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What should you expect for patient to be perscribed if experiance serotonin syndrome?
- immediately stop offending agent
- block serotonin receptors
- histamine-1 receptor antagonist Cyproheptadine
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things to do if patient is having serotonin syndrome?
- vs
- safety measure for muscle ridgity
- cooling blankets and tempid baths
- I&Os
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Symptoms of hypertensive crisis
- severe occipital headache
- palpitations
- n&v
- nuchal rigidity
- fever
- sweating
- marked increase in bp
- chest pain
- coma
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Nursing implications for hypertensive crisis
- discont drug immediatley
- vs
- administering short acting antihypertensive med as ordered
- using external cooling measures to control hyperprexia
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Foods high in tyramine AVOID
- Aged cheeses (chedder, swiss, blue, camembert,parmesan, provolone, romano, brie)
- Raisins, fava beans, flat italian beans, chinese pea pods
- red wines
- smoked and processed meats (salami, bologna, pepperoni, summer sausage)
- Caviar, picked herring, corned beef, chicken and beef liver
- Soy sauce. brewer's yeast, meat tenderizer (MSG)
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Foods moderate tyramine (May eat occasionally while on MAOI)
- gouda cheese, processed american, mozzerella
- yogurt, sour cream
- avacados bannanas
- beer white wine coffe colas tea hot chocolate
- meat extracts such as bouillion
- chocolate
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Low tyramine content ( limited quantites permissible)
- pasteurized cheeses ( cream cheese, cottage cheese, ricotta)
- figs
- distilled spirits (in moderation)
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Lifes everyday dissapointments
Affective
Behavioral
cognitive
physiological
- Transient Depression
- the "blues"
- some crying
- some difficulty getting mind off one's disappointment
- feeling tired and listless
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Normal grief response
affective
behavioral
cognitive
physiological
- Mild depression
- anger anxiety sadness denial guilt helplessness
- tearful, regression, agitation, withdrawl, restlessness
- preoccupied with loss, self blame and blaming others
- anorexia or overeating, sleep disturbances, somatic symptoms
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Associated with dysthymic disorder
affective
behavioral
cognitive
physiological
- Helpless powerless saddness gloomy and pessimistic difficultly experiancing pleasure in activites
- slow physical movements slumped posture limmited verbalization social isolation with focus on self, self destructive attitude,
- retarded thinking processes, difficulting with concentration, verbalization and behavior reflecting suicidal ideation
- aorexia, overeating sleep disturbances somatic symtos feeling best early in the morning and worse as the day progresses, amenorria, pain in head back chest abdomin
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Major depressive disorder or bipolar depression
affective
behavioral
cognitive
physiological
- Severe depression
- feeling of total despair, worthlessness, flat affect, apathy, anhedonia
- psychomotor retardation, curled up postition, not interaction with others, virtually nonexistant communitcation
- prevalent delusional thinking with delusions of persecution and somatic delusions, unable to concentrate, confusion, hallucinations refelecting miss interpretations of the environment, self blame and suicidal thoughts
- a general slow-down of entire body , anorexia, insomnia, feels worse early in the morning and somewhat better as the day progresses
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