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IDC Unit 8 > 8.4 > Flashcards

8.4 Flashcards

1
Q

Some drugs may have multiple classifications for what?

A

The same drug,

Benzodiazepines: Sedative/hypnotic, anti-anxiety and anti-seizure.

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2
Q

What are sedatives and hypnotics?

A

Are a class of drugs that cause a dose-dependent depression of the Central Nervous System (CNS) function, inducing sedation, sleep, and unconsciousness with increasing dose.

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3
Q

Class: Sedatives and Hypnotics

Agents in this class of drugs include what?

A

Barbiturates,

Benzodiazepine,

Melatonin agonists.

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4
Q

Class: Sedatives and Hypnotics

In high doses barbiturates exhibit what?

A

Anticonvulsant activity.

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5
Q

Barbiturates produce what?

A

Dose dependent respiratory depression.

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6
Q

Class: Sedatives and Hypnotics

Uses?

A

Sedation and seizures,

DO NOT USE TO TREAT INSOMNIA.

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7
Q

Class: Sedatives and Hypnotics

Adverse effects?

A

Dependence with long term use,

CNS: Somnolence,

Respiratory: Hypoventilation,

GI: Nausea,

CV: Bradycardia

Other: Agitation, confusion, nightmares, lethargy, vomiting, diarrhea, and hypotension.

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8
Q

Class: Sedatives and Hypnotics

Contraindication/Warning/Caution:

A

Hypersensitivity to phenobarbital, barbiturates or any component of the formulation,

Marked hepatic impairment,

Dyspnea or airway obstruction,

Porphyria (manifest and latent),

Intra-arterial administration,

Subcutaneous administration (not recommended),

Use in patients with a history of sedative/hypnotic addiction,

Nephritic patients (large doses).

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9
Q

Class: Sedatives and Hypnotics

Patient management?

A

Check vital signs and record,

Assess patient after giving medication for effect,

Patient Education: Abuse potential,

NaturalRemedies: Melatonin.

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10
Q

Class: Sedatives and Hypnotics

Example?

A

Phenobarbital,

Thiopental (no longer manufactured in the United States or Canada).

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11
Q

What are anti-anxiety drugs?

A

The drugs can be further subdivided into:

Benzodiazepines,

Non-Benzodiazepines.

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12
Q

Benzodiazepines are to be used for how long?

A

Short term use only.

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13
Q

Benzodiazepines are also associated with what other class of drug?

A

Sedatives and hypnotics,

Because of how they cause generalized CNS depression.

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14
Q

Class: Antianxiety

Uses?

A

Used in the management of various forms of anxiety, including generalized anxiety disorder (GAD).

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15
Q

Class: Antianxiety

Which agent is good for short term use?

A

Benzodiazepines.

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16
Q

Class: Antianxiety

Which agents are good for long term use?

A

Buspirone,

Doxepin (Tricyclics),

Fluoxetine (SSRI),

Paroxetine (SSRI),

Sertraline (SSRI),

Venlafaxine (SNRI).

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17
Q

Class: Antianxiety

Adverse effects:

Long term use of benzodiazepines?

A

Withdrawal syndrome after as little as 4-6 weeks of therapy,

Never discontinue abruptly, decrease over 4-6 weeks.

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18
Q

Class: Antianxiety

Adverse effects:

What is a good alternative to benzodiazepines for adverse effects?

A

BuSpar,

As it may have less abuse potential.

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19
Q

Class: Antianxiety

Adverse effects:

What are symptoms of withdrawal?

A

Fatigue,

Metallic taste,

HA,

Numbness in extremities,

Sweating,

Dry mouth.

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20
Q

Class: Antianxiety

Contraindication/Warning/Caution:

Should not be used in patients with what three things?

A

Comatose patients or in those with pre- existing CNS depression,

Patients with uncontrolled severe pain,

Avoid use during pregnancy or lactation.

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21
Q

Class: Antianxiety

Contraindication/Warning/Caution:

Should not be used with patients, with what eye condition?

A

Acute narrow-angle glaucoma.

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22
Q

Class: Antianxiety

Contraindication/Warning/Caution:

What pregnancy class is anti anxiety medications?

A

Pregnancy class: D,

Not recommended for use during pregnancy.

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23
Q

Class: Antianxiety

Contraindication/Warning/Caution:

Caution with impaired what?

A

Liver or kidney function.

24
Q

Class: Antianxiety

Contraindication/Warning/Caution:

BuSpar and Zolpidem are what pregnancy class?

A

Class: B.

25
Q

Class: Antianxiety

Contraindication/Warning/Caution:

Not to be taken with what other substances?

A

Alcohol,

Tricyclic antidepressants,

Other antipsychotics.

26
Q

Class: Antianxiety

Patient Management:

Use caution in older patients due to what?

A

Slow excretion.

27
Q

Class: Antianxiety

Patient Management:

Benzodiazepines are used primarily in what situation?

A

Acute situations.

28
Q

Class: Antianxiety

Patient Management:

The patient should lie down at least 30 minutes after taking what medication?

A

Benzodiazepines.

29
Q

Class: Antianxiety

Patient Management:

May be taken with or without what?

A

Food or meals.

30
Q

Class: Antianxiety

Examples:

Benzodiazepines?

A

Alprazolam: Xanax,

Diazepam: Valium,

Lorazepam: Ativan.

31
Q

Class: Antianxiety

Examples:

Non-Benzodiazepines?

A

Buspirone hydrochloride: Bu Spar,

Hydroxyzine: Atarax,

Sertraline (SSRI): May be used long term.

32
Q

Class: Antidepressants

What are the different class of antidepressants?

A

Tricyclic antidepressants (TCAs),

Monoamine Oxidase Inhibitors (MAOI),

Selective Serotonin Reuptake Inhibitors (SSRI),

Serotonin-norepinephrine reuptake inhibitors (SNRIs),

Serotonin Reuptake inhibitor/Antagonist,

Dopamine/Norepinephrine-Reuptake Inhibitor.

33
Q

Class: Antidepressants

What does TCA stand for?

A

Tricyclic antidepressants.

34
Q

Class: Antidepressants

What does MAOI stand for?

A

Monoamine Oxidase Inhibitors.

35
Q

Class: Antidepressants

What does SSRI stand for?

A

Selective Serotonin Reuptake Inhibitors.

36
Q

Class: Antidepressants

What does SNRI stand for?

A

Serotonin-norepinephrine reuptake inhibitors.

37
Q

Class: Antidepressants

Action: TCAs?

A

Increase levels of norepinephrine and serotonin by inhibiting their reuptake and blocking the action of acetylcholine.

38
Q

Class: Antidepressants

Action: MAOI?

A

Inhibits the activity of Monoamine oxidase resulting in increased endogenous neuro-hormones.

39
Q

Class: Antidepressants

Action: SSRI?

A

Increase serotonin by inhibiting neuronal uptake to CNS.

40
Q

Class: Antidepressants

MAOI picture.

A
41
Q

Class: Antidepressants

Use?

A

Depressive symptoms,

Anxiety (class dependent),

Obsessive Compulsion Disorder,

Smoking cessation: (Bupropion-Wellbutrin).

42
Q

Class: Antidepressants

Adverse Effects: TCAs?

A

Dry mouth,

Blurred vision,

Postural hypotension,

Urinary retention,

Constipation,

Orthostatic hypotension.

43
Q

TCAs adverse effects poem?

A

Blind as a bat,

Mad as a hatter,

Red as a beet,

Hot as a hare,

Dry as a bone,

The bowel and bladder lose their tone and the heart runs alone

44
Q

Class: Antidepressants

Adverse Effects: MAOI?

A

Food interactions,

Medication interactions,

Vertigo,

Nausea,

Constipation,

Dry mouth,

Headache,

Over-activity.

45
Q

Class: Antidepressants

Adverse Effects: SSRI?

A

Nausea,

Vomiting (transient),

Sexual dysfunction,

Insomnia,

Weight gain.

46
Q

Class: Antidepressants

Contraindication: TCAs?

A

Hypersensitivity to TCAs or any component of the formulation,

Co- administration with or within 14 days of MAOIs,

Acute recovery phase following myocardial infarction.

47
Q

Class: Antidepressants

Contraindication: MAOI?

A

Current use of SSRI/SNRI/DNRI/Meperidine (can cause Serotonin Syndrome),

Diet high in red wine or smoked meats/cheeses,

CVA disease,

Hypertension,

CHF,

Elderly.

MANY MEDICATION INTERACTIONS.

48
Q

Class: Antidepressants

Contraindication: Wellbutrin?

A

Is contraindicated in patients with a seizure disorder or a predisposition to seizures, as it reduces the seizure threshold.

49
Q

Class: Antidepressants

Contraindication: SSRI?

A

Fluoxetine is less effective in patients who smoke.

50
Q

Class: Antidepressants

Patient Management: How long does it take for this class to be effective?

A

May take 4-6 weeks.

51
Q

Class: Antidepressants

Patient Management: What shouldn’t you do, if you decide to stop taking this medication?

A

Do NOT stop abruptly.

52
Q

Class: Antidepressants

Patient Management: Do not take this class of drug with what other remedy?

A

St. John’s Wort.

53
Q

St John’s Wort may be a natural remedy for what?

A

Depression.

54
Q

Class: Antidepressants

Patient Management: Sertraline used with MAOI may result in what?

A

A fatal reaction (serotonin syndrome).

55
Q

Class: Antidepressants

Examples:

A

IDC Unit 8 (8 decks)

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