Aged cheeses and meats, concentrated yeast extracts, sauerkraut, and fava beans Show MAO inhibitors are rarely used in clinical practice today, mainly because they may interact with some foods and drugs to produce severe hypertension and possible heart attack or stroke. Foods that interact contain tyramine, a monoamine precursor of norepinephrine. Normally, tyramine is deactivated in the GI tract and liver so that large amounts do not reach the systemic circulation. When deactivation is blocked by MAO inhibitors, tyramine is absorbed systemically and transported to adrenergic nerve terminals, where it causes a sudden release of large amounts of norepinephrine. Foods that should be avoided include aged cheeses and meats, concentrated yeast extracts, sauerkraut, and fava beans. The medications have fewer anticholinergic effects than alternatives. Currently, the selective serotonin reuptake inhibitors (SSRIs) are the first choice for treating depression. They are preferred over the tricyclic drugs and the MAOIs because they can be less damaging to the heart and have minimal anticholinergic and hypotensive effects. The selection of one SSRI over another is based on individual patient response to a drug and prescriber preference. Adverse effects, which are mild and brief, include gastrointestinal distress (anorexia, nausea, vomiting, and diarrhea), headache, fatigue, insomnia, and sexual dysfunction (delayed ejaculation, inability to achieve orgasm). SSRIs do not necessarily eliminate the risk of suicide. Blue cheese A nurse educating a client starting phenelzine (Nardil) should educate the client to avoid containing tyramine (aged cheese, sour cream, yogurt, beef, chicken livers, pickled herring, fermented meat, undistilled alcoholic beverages, caffeinated beverages, chocolate, certain fruits and vegetables, yeast extract, and soy sauce) as the combination can result in a life-threatening hypertensive crisis. Tricyclic antidepressants Anticholinergic side effects commonly occur with the use of the tricyclic class of antidepressants. Common adverse effects for selective serotonin reuptake inhibitors are somnolence, dizziness, headache, insomnia, tremor, and weakness. Monoamine oxidase inhibitors' most common side effects include orthostatic hypotension, dizziness, vertigo, headache, and blurred vision. Adverse effects of lithium include tremors, nausea, vomiting, thirst, and polyuria. Toxic reactions may occur when serum lithium levels are greater than 1.5 mEq/L. The individual may present with a reduction in psychomotor activity. Psychomotor agitation is demonstrated in cases of major depression. A slow pace and stooped posture is characteristic of psychomotor retardation. Fidgeting is a characteristic psychomotor activity associated with depression. Physical activity also is affected in major depression. Normally one thinks of depressed patients as having psychomotor retardation, a reduction in the amount of physical activity. This type of symptom results in less motor movement; when the patients do move, they move more slowly and posture frequently is stooped with the head down; however, patients with major depression also may have psychomotor agitation. When this occurs, the patient appears restless, changes position often, and may wring his or her hands and fidget. This is not goal-directed activity, and the patient does not feel energized. p. 245 Which list orders psychotherapy approaches from most to least prevalent? psychodynamic, interpersonal, cognitive, humanistic cognitive behavioral, humanistic, psychodynamic, interpersonal humanistic, interpersonal, psychodynamic, cognitive behavioral interpersonal, cognitive behavioral, humanistic, psychodynamic
Chapters 10, 19, 20, 37, 28, 29 Terms in this set (53)Somatic symptoms: Dizziness, lethargy, nausea, vomiting, diarrhea, flulike symptoms (e.g., headache, fever, sweating, chills, malaise), insomnia, vivid dreams Psychological symptoms: Anxiety, agitation, irritability, confusion, slowed thinking Somatic symptoms- dizziness, lethargy, nausea, vomiting, diarrhea, flulike symptoms, insomnia, vivid dreams Psychological symptoms- anxiety, agitation, irritability, confusion, slowed thinking Students also viewedSets found in the same folderOther sets by this creatorRecommended textbook solutions
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Depression, may be alleviated by medication that prevents the reuptake of Quizlet
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