Serotonin Syndrome INCREASED stimulation of the CNS and peripheral serotonin

Serotonin syndrome increased stimulation of the cns

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Serotonin Syndrome INCREASED stimulation of the CNS and peripheral
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serotonin receptors, because of the excess serotonin in body! Characteristic symptoms - High fever - Confusion - Hypomania - Tachycardia - Diaphoresis - Discooradination - Seizures My d riasis d ilate Mi o tic c o nstrict Clonus: muscular spasm Serotonin Norepinephrine Reuptake Inhibitors Drugs: Duloxetine (Cymbalta) Venlafaxine (Effexor) Nefazodone (Serzone) Desvenlafaxine (Pristiq) MOA: Block’s reabsorption of both serotonin & norepinephrine. increases serotonin & norepinephrine SNRI’s Side Effects: N/V/H Constipation/gas Anxiety Abnormal vision (blurred/double vision) Dizziness Abnormal dreams/Trouble sleeping Agitation Sweating Insomnia Dry mouth Tremor Sexual dysfunction Sleeping/yawning Tricyclics Tricyclics Side Effects
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Drugs: Clomipramine(Anafranil) Doxepine(Sinequan) Nortriptyline(Pamelor) Amitriptyline(Elavil) Imapramine(Tofranil) Amoxipine(Asendin) MOA: Block’s the reuptake on serotonin & norepinephrine increases serotonin & norepinephrine levels in the synapse (decrease depression) Indications: - Major depression - OCD (Anafranil) - Panic disorder Anticholinergic response*** o can’t see o can’t pee o can’t spit o can’t shit increased appetite urinary retention fight or flight effects impaired sexual functioning weight gain Nausea blurred vision orthostatic hypotension constipation Tachycardia confusion drowsiness/weakness confusion Dry mouth hallucinations headache sensitivity to sunlight Nursing Considerations for Tricyclics Monitor suicide assessment carefully (all antidepressants) Monitor blood levels for therapeutic doses Monitor ECG for cardiotoxicity (unintentional sodium channel blocking effect causes reduced conduction velocity in the heart) Anticholinergic response: chew sugar free gum & take frequent sips of water to relieve symptoms & this will subside with time Causes a prolonged QT interval Can cause ventricular dysrhythmias Monoamine Oxidase Inhibitors (MAOI’s) Drugs: Phenelzine (Nardil) Tranylcypromine (Pamate) Selegiline (Emsam) Isocarboxazid (Marplan) MOA: Decreases metabolism of serotonin, norepinephrine, & dopamine increases serotonin, norepinephrine, & dopamine Indications: - Major depression - Panic disorder Nursing Considerations for MAOI’s Do not take CNS suppressants, EPI, OTC cold meds, antihistamines, & nasal decongestion cause HTN crisis Monitor BP Tyramine free diet*** Avoid alcohol Washed out period: time between start & stop of this & other psychotropic drugs Can also cause serotonin syndrome Don’t give at night insomnia
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- Bulimia Side effects: - Dizziness - intracerebral hemorrhage - trembling - decreased urine output - Tachycardia - Muscle twitching - constipation - fatigue - dry mouth - Risk for HTN crisis - stomach upset - increased sweating & appetite - blurred vision HTN Crisis BP >180/120 Liver cannot break down tyramine increase tyramine
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  • Spring '19
  • Hernandez, Selective serotonin reuptake inhibitor, Antidepressant

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