Thyroidism, Depression, and Digoxin

  1. What does it mean when drugs have a Narrow Therapeutic Index?
    It is a drug in which small changes in the dose and/or blood concentration could potentially result in clinically important changes in drug efficacy or safety
  2. What do drugs with Narrow Therapeutic Indexes require frequently?
    Adjustments in the dose of the drug and careful patient monitoring irrespective of whether the drug is brand or generic product
  3. What is the "Orange Book"?
    Approved drugs with therapeutic Equivalence Evaluations
  4. What is the rule associated with Narrow Therapeutic Indexes?
    Rx must be refilled with the same drug product that the pharmacist last dispensed (same manufacturer, no generics if brand was dispensed previously)
  5. Therapeutic range is also known as:
    optimal therapy
  6. What does Digoxin do chemically and what type of medication is it?
    It inhibits the sodium-potassium ATPase; it's an antiarrhythmic medication
  7. What is Digoxin used for?
    CHF, a fib, a flutter
  8. What are some of the adverse effects of Digoxin?
    Nausea, vomiting, anorexia, blurred/yellow vision
  9. What does the thyroid gland do?
    helps regulate temperature and basal rate through the use of thyroid hormones
  10. What is hyPERthyroidism?
    when there is too much of the thyroid hormone produced
  11. What is hyPOthyroidism?
    When too little thyroid hormone is produced
  12. What are some symptoms of hypERthyroidism?
    irritability/nervousness, muscle weakness/tremors, infrequent or scant menstrual periods, weight loss, sleep disturbances, enlarged thyroid gland, vision problems or eye irritation, heat sensitivity
  13. What are some symptoms of hyPOthyroidism?
    fatigue, weight gain, depression, cold intolerance, elevated cholesterol levels, heart disease, and infertility
  14. What is the generic for Synthroid, Levoxyl?
  15. What are some of the adverse side effects of Synthroid?
    hypoglycemia, insomnia, tachycardia, anxiety
  16. What is some patient education associated with Synthroid?
    do not discontinue without consulting a physician
  17. What is major depression?
    a disease with certain characteristic signs and symptoms that interferes with the ability to work, sleep, eat, and enjoy once pleasurable activities.
  18. What is the DSM-IV?
    a manual that provides diagnostic criteria for mental disorders including depression
  19. How do anti-depressant medications work?
    by slowing down the removal of certain chemicals in the brain (neurotransmitters)
  20. Why are neurotransmitters needed?
    for normal brain function and for mood control
  21. What are some major neurotransmitters in the body?
    Dopamine, GABA, Norepinephrine, Serotonin
  22. What is the role of GABA in the body?
    it is the major inhibitory neurotransmitter in the brain
  23. What are neurotransmitters produced by?
    nerve cells in the brain
  24. What are neurotransmitters used by and how are they used>
    They are used by nerves to communicate with one another
  25. What can low levels of neurotransmitters cause?
  26. What two actions can neurotransmitters complete once released into space surrounding the nerve?
    1. Either travels across space and attaches to receptors of another nerve or 2. Attaches to receptors on the nerve thatr produced it (recycled and released again or degraded)--> known as reuptake
  27. What does blocking the reuptake cause?
    higher levels of neurotransmitters so that messages can be communicated
  28. What are some diseases associated with neurotransmitter malfunction?
    depression, autism, ADD, ADHD, anxiety
  29. What does SSRI stand for?
    Selective Serotonin Reuptake Inhibitors
  30. How do SSRIs work?
    they inhibit the removal of serotonin from the brain which increases the amount of serotonin in the brain
  31. SSRI's are often used early in...
  32. How long does it take before full effect is seen with SSRIs?
    3-4 weeks
  33. What are some indications for SSRIs?
    major depression, anxiety disorders, panic disorders, obsessive-compulsive disorders, social phobias, and eating disorders
  34. What are some adverse effects of SSRIs?
    nausea, drowsiness, headache, changes in weight and appetite, changes in sexual behavior, increased feelings of depression and anxiety, tremors, and increased sweating
  35. What is some patient education associated with SSRIs?
    take as directed, may take 3-4 weeks before full effect, avoid alcohol, may impair cognitive and motor performance
  36. Are SSRIs addictive?
    No, your body cannot become physically addictive
  37. What is the required box warning on SSRI's in the US about?
    increased suicide risk in children and young adults
  38. In May 2007, what age was the warning extended to?
  39. What is the drug class and brand name for citalopram?
    SSRI; Celexa
  40. What is the drug class and brand name for escitalopram?
    SSRI; Lexapro
  41. What is the drug class and brand names for fluoxetine?
    SSRI; Prozac and Sarafem
  42. What is the drug class and brand names for paroxetine?
    SSRI, Paxil and Paxil CR
  43. What is the drug class and brand name for sertraline?
    SSRI, Zoloft
  44. What is the drug class and what are the brand names for Digoxin?
    Inotropic Agent; Lanoxin, Lanoxicaps, Digitek
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Thyroidism, Depression, and Digoxin
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