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what are the 4 main groups of antidepressants?
2) Atypical antidepressants
3) Tricylic antidepressants (TCAs)
4) MAOIs (monoamine oxidase inhibitors)
when a depressive client is admitted to the hospital and before the therapeutic effects have taken place what does the nurse want to do?
put client on suicide watch
what are the SSRIs used to treat depressive disorders?
1) fluoxetine (Prozac)
2) citalopram (Celexa)
3) escitalopram (Lexapro)
4) paroxetine (Paxil)
5) sertraline (Zoloft)
6) vilazodone (Viibryd)
Citalopram
Celexa
cilazodone
Viibryd
therapeutic uses of fluoxetine
major depression, OCD, bulimia nervosa, premenstrual dysphoric disorders (PMDD), panic disorders, postraumatic stress disorder
what are the adverse effects of fluoxetine?
1) sexual dysfunction
2) CNS stimulation
3) weight loss early in treatment, possible weight gain late in treatment
4) serotonin syndrome
5) withdrawal syndrome
6) hyponatremia
7) rash
8) sleepiness, faintness, lightheadedness
9) GI bleeding
10) bruxism
what are the symptoms of the adverse effects CNS stimulation when taking fluoxetine?
inability to sleep, agitation, anxiety
what are the nursing interventions for the adverse effects of fluoxetine?
1. sexual dysfunction -- inform of effects and tell provider, can manage sexual dysfunction through lower dosage, med holiday, and using adjunct medications
2) cns stimulation -- notify provider dose made need to be lowered, take dose in morning, advise against caffeinated drinks, teach relaxation techniques to promote sleep
3) weight changes -- monitor weight, regular exercise and healthy diet
4) serotonin syndrome -- observe for manifestations, notify provider and withhold med
5) withdrawal syndrome -- taper dose
6) hyponatremia -- baseline, monitor
7) rash -- treatable with antihistamine or withdrawal of med
8) sleepiness etc -- advise not common but can occur, advise avoid driving/heavy machinery
9) GI bleeding -- hx of GI problems/taking coagulant meds
10) bruxism -- report to provider, mouth guard, change or add low dose buspirone
What Pregnacy Risk Category are most SSRIs? which 2 increase the risk of birth defects? late in pregnancy what can SSRIs do?
C; fluoxetine and paroxetine; increases risk of withdrawal symptoms or pulmonary hypertension in the newborn
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