Welcome to Episode 148 of the Nursing Show

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News–

C-Section Rates Getting Higher

Nursing Students Scramble for Funds

US Birth Rate Falls in Midst of Recession

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This Week- Antidepressant Overdose with Lisa Booze of the Maryland Poison Center

According to the World Health Organization, depression affects about 121 million people worldwide and is a leading cause of disability. This is why antidepressants are widely used especially in the US. Symptoms of depression manifested are not the same for different individuals so the type of antidepressant and dose to be taken should be chosen with caution.

The different classifications of antidepressants are:

  • Selective Serotonin Reuptake Inhibitors (SSRI)
    • eg. Prozac (fluoxetine), Paxil (paroxetine)
  • Serotonin and Norepinephrine Reuptake Inhibitors (SSNIs)
    • eg. )Effexor (venlafaxine), Cymbalta (duloxetine)
  • Tricyclic antidepressants (TCAs)
    • eg. Elavil (amitriptyline), Tofranil (imipramine)
  • Monoamine Oxidase Inhibitors (MAOIs)
    • eg. Nardil (phenelzine), Parnate (tranylcypromine)

SSRI’s are regarded as first-line therapy for depression but TCAs remain to be widely used not only for depression but also for other conditions like anxiety disorders, ADD, pediatric enuresis and chronic pain disorders. Overdose from TCAs are among the most common causes of drug poisoning seen in emergency departments.

Tricyclics are identified as one of the most frequently ingested substances in poisoning along with paracetamol, benzodiazepines and alcohol. They are second to analgesics as most common drug taken in fatal drug overdose.

Management of antidepressant overdose includes measures to reduce absorption, alkalinisation, providing anti-arrhythmic treatment, management of hypotension and convulsions. Patients should also be closely monitored for risk of cardiac arrest and seizure precautions should be instituted.

Emergency Medicine Journal Review on Tricyclic Antidepressant Overdose

Understanding Antidepressant Medications

Article on Antidepressant Toxicity

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Song this week:

Matthew Ebel with “Downtown”

Matthew Ebel on iTunes song called DownTown

Click here to get Songs from the MedicCast at the iTunes Store.

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Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

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