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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NP 4 Exam 2

Concepts Covered:

  • Circulatory System
  • Urinary System
  • Adult
  • Basic
  • Test Taking Strategies
  • Prefixes
  • Suffixes
  • Integumentary Disorders
  • Respiratory Disorders
  • Pediatric
  • Bipolar Disorders
  • Immunological Disorders
  • Labor Complications
  • Neonatal
  • Medication Administration
  • Disorders of Pancreas
  • Pregnancy Risks
  • Cardiac Disorders
  • Learning Pharmacology
  • Eating Disorders
  • Dosage Calculations
  • Emergency Care of the Cardiac Patient
  • Substance Abuse Disorders
  • Vascular Disorders
  • Endocrine and Metabolic Disorders
  • Shock
  • Fetal Development
  • Depressive Disorders
  • Anxiety Disorders
  • Cardiovascular Disorders
  • Liver & Gallbladder Disorders
  • Upper GI Disorders
  • Female Reproductive Disorders
  • Neurologic and Cognitive Disorders
  • Personality Disorders
  • Nervous System
  • Urinary Disorders
  • Hematologic Disorders
  • Disorders of the Posterior Pituitary Gland
  • Respiratory System
  • Renal Disorders
  • Noninfectious Respiratory Disorder
  • Shock

Study Plan Lessons

EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Life Support Review Course Introduction
12 Points to Answering Pharmacology Questions
CPR-BLS (Basic Life Support)
Electrical A&P of the Heart
54 Common Medication Prefixes and Suffixes
Advanced Cardiovascular Life Support (ACLS)
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid Pressures
Vitals (VS) and Assessment
Fluid Shifts (Ascites) (Pleural Effusion)
Pediatric Advanced Life Support (PALS)
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Essential NCLEX Meds by Class
Isotonic Solutions (IV solutions)
Neonatal Resuscitation Program (NRP)
6 Rights of Medication Administration
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Preload and Afterload
Performing Cardiac (Heart) Monitoring
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Basics of Calculations
The EKG (ECG) Graph
Nursing Care and Pathophysiology of Angina
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
EKG (ECG) Waveforms
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Oral Medications
Chloride-Cl (Hyperchloremia, Hypochloremia)
Injectable Medications
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
IV Infusions (Solutions)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Complex Calculations (Dosage Calculations/Med Math)
Phosphorus-Phos
Normal Sinus Rhythm
Normal Sinus Rhythm
Nursing Care and Pathophysiology for Heart Failure (CHF)
Sinus Bradycardia
Sinus Bradycardia
Sinus Tachycardia
Sinus Tachycardia
Atrial Flutter
Pacemakers
Atrial Fibrillation (A Fib)
Atrial Fibrillation (A Fib)
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Benzodiazepines
Nursing Care and Pathophysiology of Hypertension (HTN)
Cardiac (Heart) Disease in Pregnancy
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Dehydration
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
MAOIs
SSRIs
TCAs
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
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
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acute Coronary Syndrome (ACS) Module Intro
Base Excess & Deficit
Blood Flow Through The Heart
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Course Introduction
Cardiovascular Disorders (CVD) Module Intro
Coronary Circulation
Fluid Compartments
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Hemodynamics
Lactic Acid
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
MI Surgical Intervention
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Pacemakers
Performing Cardiac (Heart) Monitoring
Potassium-K (Hyperkalemia, Hypokalemia)
Preload and Afterload
Proton Pump Inhibitors
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Shock Module Intro
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)