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Chapter 18 Psychotropic > Anxiety and Sleep > Flashcards

Anxiety and Sleep Flashcards

1
Q

Benzodiazepines used in ANXIETY

A 
Alprazolam (Xanax)
Bromazepam (Lexotan)
Clobazam (Frisium)**
Diazepam (Valium)
Lorazepam (Ativan)**
Oxazepam (Serepax)**
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2
Q

Benzodiazepines used in INSOMNIA

A 
Clobazam (Frisum)**
Flunitrazepam (Hypnodorm)
Lorazepam (Ativan)**
Nitrazepam (Alodrom or Mogadon)
Oxazepam (Serepax)**
Tempazepam (Temaze)
Triazolam (Halcion)
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3
Q

Alprazolam (Xanax)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)

  1. Anxiety
  2. Panic Disorder

C)
0.25 - 10 mg daily

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1, 9, 18 (CYP3A4 substrate)

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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4
Q

Bromazepam (Lexotan)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)
1. Anxiety

C)
3-12 mg BD or TDS
Max 60 mg daily

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1, 3b, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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5
Q

Clobazam (Frisium)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)

  1. Anxiety
  2. Insomnia (short-term)
  3. Epilepsy

C)
10-80 mg daily

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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6
Q

Diazepam (Valium)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)

  1. Anxiety (short-term)
  2. Acute Alcohol Withdrawal
  3. Muscle spasm
  4. Premedication
  5. Conscious Sedation
  6. Status Epilepticus
  7. Benzodiazepine Withdrawal
  8. Acute Behavioural Disturbances
  9. Parasomnias (Night terrors, Sleepwalking)

C)
1-10 mg TDS
Max 30 mg daily

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a (parasomnias), 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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7
Q

Clonazepam (Paxam)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine Anticonvulsant

B)

  1. Epilepsy (refractory)
  2. Status Epilepticus

C)
0.5 - 8 mg daily (divided doses)

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1, 9, A* (swallow whole)

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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8
Q

Flunitrazepam (Hypnodorm)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)
1. Insomnia

C)
0.5 - 2 mg NOCTE

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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9
Q

Lorazepam (Ativan)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)

  1. Anxiety
  2. Insomnia (short-term)
  3. Premedication
  4. Anticipatory Nausea and Vomiting (chemo)

C)
1 - 4 mg daily

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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10
Q

Nitrazepam (Alodrom / Mogadon)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)

  1. Insomnia
  2. Infantile spasms

C)
2.5 - 20 mg NOCTE

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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11
Q

Oxazepam (Serepax / Murelax)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)

  1. Anxiety
  2. Insomnia (short-term)

C)
7.5 - 30 mg TDS or QID
Max 120 mg daily

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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12
Q

Temazepam (Temaze)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)
1. Insomnia

C)
5-20 mg NOCTE

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a, 9

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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13
Q

Triazolam (Halcion)

A

Take this medicine for as long as your doctor recommends.

A) Benzodiazepine

B)
1. Insomnia (short-term)

C)
0.125 - 0.5 mg NOCTE

D)

  1. Tolerance and DEPENDENCE**
  2. WITHDRAWAL symptoms** (anxiety, dysphoria, irritability, insomnia, sweating, etc)
  3. DURATION (short-term only)
  4. RESPIRATORY depression
  5. SEDATION score
  6. Periodic Blood Counts (blood disorders - leucopenia and leucocytosis - rare)
  7. Renal
  8. Hepatic

E)
Labels: 1 or 1a, 9, 18 (CYP3A4 substrate)

#It’s usually taken only for SHORT PERIODS (2-4 weeks). Your body may become used to it and in time you may need a higher dose
#Discuss how to STOP this medication with your doctor.
#Avoid ALCOHOL and other medications that cause drowsiness.
S/E:
*Initially cause LIGHT-HEADEDNESS, DIZZINESS, CONSTIPATION, DRY MOUTH and NAUSEA
*DROWSINESS and DIZZINESS may persist onto the following day

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14
Q

Melatonin (Circadin)

A

A) Melatonin MT1/MT2 receptor agonist

B)
1. PRIMARY INSOMNIA with POOR SLEEP QUALITY

C)
2 mg (1-2 hrs before bedtime) for up to 13 weeks
D) 
1. AGE (dose >55 years)
2. BACK PAIN
3. Clinical Improvement
4. HEPATIC
NO renal

E)
Labels: A (Swallow whole)
#Swallow tablets whole WITH FOOD
#Do not drink ALCOHOL while using Melatonin as it can affect the way the medicine works
#Take this only as often and as long as your doctor recommends
S/E
Back pain, Myalgia and Weakness

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15
Q

Zolpidem (Stillnox)

A

A) Non-benzodiazepine Hypnotic

B)
1. Insomnia (short-term)

C)
IR: 5-10 mg NOCTE
CR: 6.25 -12.5 mg NOCTE

D)
1. MOOD changes*** (depression, psychosis or schizophrenia may worsen)
2. SLEEP WALKING behaviour**
3. DEPENDENCE**
4. WITHDRAWAL syndrome**
5. HEPATIC (hepatotoxicity)
NO renal

E)
Labels: 1a, 2, A* (CR)
#Should start to work within 30 mins
#Short duration (2-4 weeks)
#Avoid driving or operating heavy equipment for AT LEAST 8 hrs after taking your tablet and possibly longer
#Do not take ALCOHOL or other medications that may cause drowsiness as this may increase the risk of SLEEP WALKING or DRIVING while you’re asleep
S/E:
*GIT (diarrhoea)
*CNS (impaired alertness the next morning, drowsiness, hallucinations, amnesia)

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16
Q

Zopiclone (Imovane)

A

A) Non-benzodiazepine hypnotic

B)
1. Insomnia (short-term)

C)
3.75 - 7.5 mg NOCTE

D)
1. DEPENDENCE
2. MISUSE
3. WITHDRAWAL syndrome
4. SLEEP-WALKING (rarer than zolpidem)
5. HEPATIC
NO renal

E)
Labels: 1a, 2
#You may feel less alert or even drowsy the FOLLOWING DAY
#Avoid ALCOHOL and other drowsy medications
#Short period of duration (2-4 weeks)
S/E
*MOUTH (bitter taste, dry mouth)
*CNS (drowsiness, nightmares, hallucinations)

Chapter 18 Psychotropic (8 decks)

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