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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Pharmacology Exam III

Concepts Covered:

  • Oncology Disorders
  • Concepts of Pharmacology
  • Medication Administration
  • Nervous System
  • Adulthood Growth and Development
  • Bipolar Disorders
  • Substance Abuse Disorders
  • Depressive Disorders
  • Disorders of Pancreas
  • Intraoperative Nursing
  • Anxiety Disorders
  • Disorders of the Adrenal Gland
  • Central Nervous System Disorders – Brain
  • Hematologic Disorders
  • Respiratory Disorders
  • Cardiac Disorders
  • Immunological Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Cardiovascular Disorders
  • Urinary System
  • Personality Disorders
  • Psychotic Disorders
  • Peripheral Nervous System Disorders
  • Urinary Disorders
  • Pregnancy Risks
  • Female Reproductive Disorders
  • Neurologic and Cognitive Disorders
  • Noninfectious Respiratory Disorder
  • Learning Pharmacology

Study Plan Lessons

Antineoplastics
Pharmacokinetics
Pharmacodynamics
Parasympathomimetics (Cholinergics) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Mood Stabilizers
Methadone (Methadose) Nursing Considerations
MAOIs
Interactive Pharmacology Practice
Insulin Mixing
Insulin Drips
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin
Glipizide (Glucotrol) Nursing Considerations
Barbiturates
Antidepressants
Antianxiety Meds
Addisons Assessment Nursing Mnemonic (STEROID)
Anticonvulsants
Antianxiety Meds
Barbiturates
MAOIs
Phenobarbital (Luminal) Nursing Considerations
TCAs
Anti Tumor Antibiotics
Alkylating Agents
Sedatives-Hypnotics
Lithium (Lithonate) Nursing Considerations
Pentobarbital (Nembutal) Nursing Considerations
Fluticasone (Flonase) Nursing Considerations
Corticosteroids
Antidiabetic Agents
Sympatholytics (Alpha & Beta Blockers)
Epoetin Alfa
Cyclosporine (Sandimmune) Nursing Considerations
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Propylthiouracil (PTU) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Cardiac Glycosides
Calcium Channel Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Metoprolol (Toprol XL) Nursing Considerations
Renin Angiotensin Aldosterone System
Atypical Antipsychotics
Chlorpromazine (Thorazine) Nursing Considerations
Antipsychotics
Haloperidol (Haldol) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Neostigmine (Prostigmin) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Autonomic Nervous System (ANS)
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Proton Pump Inhibitors
Ondansetron (Zofran) Nursing Considerations
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Amitriptyline (Elavil) Nursing Considerations
Sertraline (Zoloft) Nursing Considerations
Paroxetine (Paxil) Nursing Considerations
Fluoxetine (Prozac) Nursing Considerations
Escitalopram (Lexapro) Nursing Considerations
SSRIs
Bupropion (Wellbutrin) Nursing Considerations
Antidepressants
Phenytoin (Dilantin) Nursing Considerations
Levetiracetam (Keppra) Nursing Considerations
Lamotrigine (Lamictal) Nursing Considerations
Gabapentin (Neurontin) Nursing Considerations
Carbamazepine (Tegretol) Nursing Considerations
Antianxiety Meds
Buspirone (Buspar) Nursing Considerations
Diazepam (Valium) Nursing Considerations
Midazolam (Versed) Nursing Considerations
Lorazepam (Ativan) Nursing Considerations
Alprazolam (Xanax) Nursing Considerations
Benzodiazepines
Disease Specific Medications
Pharmacology Course Introduction
The SOCK Method – Overview