1. What are the main classes of antidepressants and how do they work? Provide
an example of a drug for each class.
- The main classes of antidepressants are selective serotonin reuptake inhibitors
(SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic
antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and atypical
antidepressants. They work by increasing the availability of neurotransmitters
such as serotonin, norepinephrine, and dopamine in the brain, which are involved
in mood regulation. Examples of drugs for each class are fluoxetine (SSRI),
venlafaxine (SNRI), amitriptyline (TCA), phenelzine (MAOI), and bupropion
(atypical).
2. What are the common side effects and contraindications of antipsychotics?
How can nurses monitor and manage these effects?
- The common side effects of antipsychotics are extrapyramidal symptoms
(EPS), such as dystonia, akathisia, parkinsonism, and tardive dyskinesia;
metabolic syndrome, such as weight gain, diabetes, and dyslipidemia; sedation,
orthostatic hypotension, anticholinergic effects, such as dry mouth, constipation,
and urinary retention; and neuroleptic malignant syndrome (NMS), a rare but
life-threatening condition characterized by fever, muscle rigidity, altered mental
status, and autonomic instability. Antipsychotics are contraindicated in patients
with hypersensitivity, severe cardiovascular disease, blood dyscrasias, liver
impairment, or narrow-angle glaucoma. Nurses can monitor and manage these
effects by assessing the patient's vital signs, blood glucose, lipid profile, liver
function tests, complete blood count, and mental status; educating the patient
about the signs and symptoms of EPS and NMS and the importance of
medication adherence; providing supportive measures such as hydration, cooling,
and antipyretics for NMS; administering anticholinergic agents or
benzodiazepines for EPS; and encouraging the patient to adopt a healthy lifestyle
such as diet, exercise, and smoking cessation.
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