McKenna's Pharmacology for Nursing, 2e

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C H A P T E R 2 1 Antidepressant agents

3. Adverse effects may limit the usefulness of TCAs with some people. Care interventions that could alleviate some of the unpleasant aspects of these adverse effects include: a. always administering the drug when the person has an empty stomach. b. reminding the person not to void before taking the drug. c. increasing the dose to override the adverse effects. d. taking the major portion of the dose at bedtime to avoid experiencing drowsiness and the unpleasant anticholinergic effects. 4. You might question an order for an MAO inhibitor as a first step in the treatment of depression, remembering that these drugs are reserved for use in cases in which there has been no response to other agents because: a. MAO inhibitors can cause hair loss. b. MAO inhibitors are associated with potentially serious drug–food interactions. c. MAO inhibitors are mostly recommended for use in people undergoing surgery. d. MAO inhibitors are more expensive than other agents. 5. A woman is being treated for depression and is started on a regimen of Prozac (fluoxetine). She calls you 10 days after the drug therapy has started to report that nothing has changed and she wants to try a different drug. You should: a. tell her to try sertraline ( Zoloft ) because some people respond to one SSRI and not another. b. ask her to try a few days without the drug to see whether there is any difference. c. add an MAO inhibitor to her drug regimen to get an increased antidepressant effect. d. encourage her to keep taking the drug as prescribed because it usually takes up to 4 weeks to see the full antidepressant effect. 6. The drug of choice for a person with a documented obsessive–compulsive disorder who is also suffering from depression and occasional panic disorder would be: a. Cipramil.

7. Venlafaxine ( Efexor ) is a relatively new antidepressant that might be very effective for use in people who: a. have proven to be responsive to other antidepressants. b. can tolerate multiple side effects. c. are reliable at taking multiple daily dosings. d. have not responded to other antidepressants and would benefit from once-a-day dosing.

8. Depression is an affective disorder that is: a. always precipitated by a specific event.

b. most common in people with head injuries. c. characterised by overwhelming sadness, despair and hopelessness. d. very evident and easy to diagnose in the clinical setting.

MULTIPLE RESPONSE Select all that apply.

1. Depression is a very common affective disorder that strikes many people. In assessing a person who might be suffering from depression, the nurse or midwife would expect to find which of the following?

a. lack of energy b. hyperactivity c. sleep disturbances d. libido problems e. confusion f. decreased reflexes

2. A person reports that he thinks he is taking an antidepressant, but he is not sure. In reviewing his medication history, which of the following drugs would be considered antidepressants? a. tetracyclic drugs b. cholinergics c. SSRIs d. MAO inhibitors e. angiotensin II receptor blockers (ARBs) f. benzodiazepines

b. Aropax. c. Luvox. d. Prozac.