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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My Study Plan

Concepts Covered:

  • Concepts of Pharmacology
  • Test Taking Strategies
  • Prefixes
  • Suffixes
  • Bipolar Disorders
  • Immunological Disorders
  • Medication Administration
  • Learning Pharmacology
  • Dosage Calculations
  • Noninfectious Respiratory Disorder
  • Anxiety Disorders
  • Substance Abuse Disorders
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Vascular Disorders
  • Acute & Chronic Renal Disorders
  • Neurologic and Cognitive Disorders
  • Depressive Disorders
  • Disorders of Pancreas
  • Female Reproductive Disorders
  • Liver & Gallbladder Disorders
  • Integumentary Disorders
  • Pregnancy Risks
  • Upper GI Disorders
  • Urinary System
  • Central Nervous System Disorders – Brain
  • Cardiovascular Disorders
  • Microbiology
  • Infectious Respiratory Disorder
  • Shock
  • Male Reproductive Disorders
  • Labor Complications
  • Sexually Transmitted Infections
  • Respiratory Disorders
  • EENT Disorders
  • Urinary Disorders
  • Personality Disorders
  • Psychotic Disorders
  • Nervous System
  • Peripheral Nervous System Disorders
  • Gastrointestinal Disorders
  • Neurological
  • Lower GI Disorders
  • Hematologic Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Postpartum Complications
  • Prenatal Concepts
  • Newborn Care
  • Intraoperative Nursing
  • Postoperative Nursing
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

Pharmacology Course Introduction
12 Points to Answering Pharmacology Questions
54 Common Medication Prefixes and Suffixes
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Essential NCLEX Meds by Class
6 Rights of Medication Administration
Pharmacodynamics
Pharmacokinetics
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Oral Medications
Injectable Medications
IV Infusions (Solutions)
Complex Calculations (Dosage Calculations/Med Math)
Disease Specific Medications
Antianxiety Meds
Benzodiazepines
Alprazolam (Xanax) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
Procainamide (Pronestyl) Nursing Considerations
Clopidogrel (Plavix) Nursing Considerations
Warfarin (Coumadin) Nursing Considerations
Enoxaparin (Lovenox) Nursing Considerations
Heparin (Hep-Lock) Nursing Considerations
Alteplase (tPA, Activase) Nursing Considerations
Streptokinase (Streptase) Nursing Considerations
Carbamazepine (Tegretol) Nursing Considerations
Divalproex (Depakote) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Phenytoin (Dilantin) Nursing Considerations
Antidepressants
Bupropion (Wellbutrin) Nursing Considerations
MAOIs
Selegiline (Eldepyrl) Nursing Considerations
SSRIs
Escitalopram (Lexapro) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
TCAs
Glipizide (Glucotrol) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Insulin
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Histamine 1 Receptor Blockers
Diphenhydramine (Benadryl) Nursing Considerations
Promethazine (Phenergan) Nursing Considerations
Histamine 2 Receptor Blockers
Cimetidine (Tagamet) Nursing Considerations
Famotidine (Pepcid) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Renin Angiotensin Aldosterone System
Atenolol (Tenormin) Nursing Considerations
Metoprolol (Toprol XL) Nursing Considerations
Propranolol (Inderal) Nursing Considerations
ACE (angiotensin-converting enzyme) Inhibitors
Captopril (Capoten) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Angiotensin Receptor Blockers
Losartan (Cozaar) Nursing Considerations
Calcium Channel Blockers
Amlodipine (Norvasc) Nursing Considerations
Diltiazem (Cardizem) Nursing Considerations
Nifedipine (Procardia) Nursing Considerations
Verapamil (Calan) Nursing Considerations
Cardiac Glycosides
Digoxin (Lanoxin) Nursing Considerations
Gentamicin (Garamycin) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Nystatin (Mycostatin) Nursing Considerations
Isoniazid (Niazid) Nursing Considerations
Rifampin (Rifadin) Nursing Considerations
Acyclovir (Zovirax) Nursing Considerations
Meropenem (Merrem) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Levofloxacin (Levaquin) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Clindamycin (Cleocin) Nursing Considerations
Erythromycin (Erythrocin) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Amoxicillin (Amoxil) Nursing Considerations
Ampicillin (Omnipen) Nursing Considerations
Cefaclor (Ceclor) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Cephalexin (Keflex) Nursing Considerations
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Tetracycline (Panmycin) Nursing Considerations
Atypical Antipsychotics
Chlorpromazine (Thorazine) Nursing Considerations
Antipsychotics
Haloperidol (Haldol) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Olanzapine (Zyprexa) Nursing Considerations
Autonomic Nervous System (ANS)
Methylphenidate (Concerta) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Dobutamine (Dobutrex) Nursing Considerations
Dopamine (Inotropin) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Albuterol (Ventolin) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Salmeterol (Serevent) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Furosemide (Lasix) Nursing Considerations
Hydrochlorothiazide (Hydrodiuril) Nursing Considerations
Spironolactone (Aldactone) Nursing Considerations
Mannitol (Osmitrol) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Lactulose (Generlac) Nursing Considerations
Loperamide (Imodium) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Ondansetron (Zofran) Nursing Considerations
Pancrelipase (Pancreaze) Nursing Considerations
Sucralfate (Carafate) Nursing Considerations
Proton Pump Inhibitors
Omeprazole (Prilosec) Nursing Considerations
Pantoprazole (Protonix) Nursing Considerations
Epoetin Alfa
Epoetin (Epogen) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Propylthiouracil (PTU) Nursing Considerations
Cyclosporine (Sandimmune) Nursing Considerations
HMG-CoA Reductase Inhibitors (Statins)
Atorvastatin (Lipitor) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Magnesium Sulfate (MgSO4) Nursing Considerations
Calcium Acetate (PhosLo) Nursing Considerations
Calcium Carbonate (Tums) Nursing Considerations
Ferrous Sulfate (Iron) Nursing Considerations
Alendronate (Fosamax) Nursing Considerations
Mood Stabilizers
Lithium (Lithonate) Nursing Considerations
Acetaminophen (Tylenol) Nursing Considerations
Phenazopyridine (Pyridium) Nursing Considerations
NSAIDs
ASA (Aspirin) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Ibuprofen (Motrin) Nursing Considerations
Indomethacin (Indocin) Nursing Considerations
Ketorolac (Toradol) Nursing Considerations
Naproxen (Aleve) Nursing Considerations
Tocolytics
Terbutaline (Brethine) Nursing Considerations
Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations
Meds for Postpartum Hemorrhage (PPH)
Methylergonovine (Methergine) Nursing Considerations
Oxytocin (Pitocin) Nursing Considerations
Prostaglandins in Pregnancy
Rh Immune Globulin in Pregnancy
Lung Surfactant for Newborns
Eye Prophylaxis for Newborn
Phytonadione (Vitamin K) for Newborn
Hepatitis B Vaccine for Newborns
Opioid Analgesics in Pregnancy
Butorphanol (Stadol) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Fentanyl (Duragesic) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Morphine (MS Contin) Nursing Considerations
Nalbuphine (Nubain) Nursing Considerations
Oxycodone (OxyContin) Nursing Considerations
Sedatives-Hypnotics
Phenobarbital (Luminal) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Lidocaine (Xylocaine) Nursing Considerations
Corticosteroids
Betamethasone and Dexamethasone in Pregnancy
Cortisone (Cortone) Nursing Considerations
Dexamethasone (Decadron) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Methylprednisolone (Solu-Medrol) Nursing Considerations
Hydralazine
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
Nitroprusside (Nitropress) Nursing Considerations
Vasopressin
Epinephrine (EpiPen) Nursing Considerations
Norepinephrine (Levophed) Nursing Considerations
Vasopressin (Pitressin) Nursing Considerations