SSRIs

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Tarang Patel
DNP-NA,RN,CCRN, RPh
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Included In This Lesson

Study Tools For SSRIs

Antidepressant Cheat Sheet (Cheatsheet)
140 Must Know Meds (Book)
Selective Serotonin Reuptake Inhibitor (SSRI) Overview (Picmonic)
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Outline

Overview

  1. SSRI’s- one of the four classes of antidepressants
  2. Mechanism of action
    1. Prevents reuptake of serotonin
    2. Making serotonin more available in the body

Nursing Care

Overview

  1. One of the safest antidepressants
    1. Fewer side effects
    2. Good safety margin
  2. Examples
    1. Citalopram
    2. Escitalopram
    3. Paroxetine
    4. Sertraline
    5. Fluoxetine

Assessment

  1. Assess for side effects
    1. Sexual dysfunction
    2. Nausea
    3. Headache
    4. Weight gain
    5. Anxiety
    6. Insomnia
    7. Serotonin Syndrome
      1. If SSRI taken with other antidepressants
      2. Hypertension
      3. Confusion
      4. Anxiety
      5. Tremors
      6. Ataxia
      7. Hyperpyrexia
      8. Sweating

Therapeutic Management

  1. Wait at least 2-3 weeks before starting SSRI if patient was on another type of antidepressant
  2. Place patient on suicide precaution due to increase in suicidal tendency.

Nursing Concepts

  1. Mood Affect
    1. SSRI’s are commonly prescribed to treat depression.
  2. Pharmacology

Patient Education

  1. Educate patients on the signs and symptoms of Serotonin Syndrome and instruct them to contact their provider immediately if they experience them.

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Transcript

Okay, so, antidepressant medication main four classes, we gonna take a look at the Selective Serotonin reuptake inhibitors in this video. One of the safest class of drugs for depression, widely used nowadays because of low side effects and good safety margin.

Alright. Let’s take a look about the mechanism of action. So, this medication prevents the reuptake of serotonin into the presynaptic nerve terminals. And, when it prevents the reuptake, that means, it makes serotonin more available in the brain. And what of the proposed theory for the depression, the cause of depression is low serotonin level. Now, when this medication prevents reuptake, and make the serotonin available for more time, it will increase the level of serotonin in the brain and will eventually cause, will eventually relieve the symptoms of depression. They have a low side effects, since this is like specifically for serotonin, like if you have watched the videos for tricyclic antidepressant and monoamino oxidase inhibitors. For example, tricyclic works on norepinephrine and serotonin, both. Monoamine works on several of them, like norepinephrine, epineprhine, serotonin and dopamine. So, they have more side effects because it increases the level of more than one neurotransmitter while we require only serotonin. So, they will cause more side effects while this one specifically works on serotonin. They increase in the level of serotonin, this one has low side effects and high safety margin. And, they are the preferred medication for depression and other mood disorder. Like, when I say, other mood disorder, like there are some disorders like obsessive compulsive disorders, like those, sometime they use this medication for bipolar. Because in bipolar, there are 2 phases of bipolar manic. Like if you know about the bipolar, this manic phase and depression. Now, in depression, they will use this medication for that. However, the most often used medication for bipolar, this lithium we already talk about, but they may use this antidepression medication in bipolar as well. So, if someone has a only obstacle, problems like repetitive talks, like that, to stabilize the mood, they may use this medication as well. So, they are used for more than one mood disorders, only for the depression, that’s what I meant to say.

Their side effects, the main side effects is the sexual dysfunction, nausea, headache, weight gain and anxiety and insomnia are the other side effects that you don’t see often. The sexual dysfunction is the main one. There’s a other side effects, it’s called the serotonin syndrome. It can happen like as we talked in previous videos of MAOIs (Monoamine oxidase inhibitors) and Tricyclic Antidepression, that if you take these drugs at the same time, it can cause really bad side effects. When you stop with medication, an any kind of medication antidepression, you have to wait for 2 -3 weeks before you start another class of medication. However, sometime, if they do start within 2 -3 weeks, it can cause a serotonin syndrome. And, basically, it causes the hypertension, confusion, anxiety, tremors, ataxia, hyperpyrexia and sweating. So, that’s the one you need to really look for. So, whenever you change medication for these patients for depression, wait at least 2 – 3 weeks, otherwise, it will cause severe side effects.

The examples for this medication is Citalopram, Escitalopram, Paroxetine, Sertraline and Fluoxetine. Now, here’s another thing to remember for this medication is, for any kind of antidepression, they are, if they are on this medication, they are more prone, they have more suicidal tendency. So, even if they are on MAOIs, which is monoamine oxidase inhibitors, tricyclic antidepressions or this SSRIs which is selective serotonin reuptake inhibitors, they are more prone for suicidal tendency. So, if you have a patient who recently started on this medication, you have to put them on suicide precautions. So, that’s another thing to remember about this medications as well.

I hope you like this and learned about this antidepression medication very well. If you have any questions about this medication, feel free to ask us. Thanks for watching.

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Study Plan Lessons

12 Points to Answering Pharmacology Questions
Glaucoma
Glaucoma
54 Common Medication Prefixes and Suffixes
Addisons Disease
Burn Injuries
Burn Injuries
Cataracts
Cataracts
Nursing Care and Pathophysiology for Cushings Syndrome
Macular Degeneration
Macular Degeneration
Pressure Ulcers/Pressure injuries (Braden scale)
Pressure Ulcers/Pressure injuries (Braden scale)
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Essential NCLEX Meds by Class
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
6 Rights of Medication Administration
Hearing Loss
Hearing Loss
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology of Osteoporosis
Thrombocytopenia
Blood Transfusions (Administration)
Fractures
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Integumentary (Skin) Important Points
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Hypothyroidism
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Generalized Anxiety Disorder
Leukemia
Diabetes Management
Lymphoma
Oral Medications
Post-Traumatic Stress Disorder (PTSD)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Injectable Medications
Oncology Important Points
Somatoform
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Benzodiazepines
MAOIs
SSRIs
TCAs
Insulin
Histamine 1 Receptor Blockers
Histamine 2 Receptor Blockers
Renin Angiotensin Aldosterone System
ACE (angiotensin-converting enzyme) Inhibitors
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Proton Pump Inhibitors
Schizophrenia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)