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Kol- Pharm 323 Spring > Anxiety/Hypnotic > Flashcards

Anxiety/Hypnotic Flashcards

1
Q

this class of drug suppresses the nervous system

A

sedative

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2
Q

hypnotic vs anxiolytic fxn

A

Anxiety relief = anxiolytics

Promote sleep = hypnotics

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3
Q

A lot of the sedatives are used for anxiety or insomnia management. What determines that difference?

A

Dosage!

Low = anxiety relief
High = sleep induction
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4
Q

2 classes of hypnotics

A
  1. Benzodiazepines
    - ->*drug of choice
  2. Benzodiazepine-like drugs
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5
Q

which hypnotic class is drug of choice for sleep induction?

A

Benzodiazepines

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6
Q

Why do we like Benzodiazepines more than barbituates?

A

SAFER!

  • ->Lower potential for abuse
  • ->Fewer drug interactions
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7
Q

prototype for benzodiazepines for hypnotic

A

triazolam (Halcion)

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8
Q

benzodiazepines for anxiety (3)

A

lorazepam (Ativan) ,
alprazolam (Xanax)
diazepam (Valium),

(this LAD Ben is making me anxious)

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9
Q

Random benzo used for procedures prototype

A

midazolam (Versed)

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10
Q

What schedule drugs are benzodiazepines

A

schedule IV!

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11
Q

How do all benzodiazepines fxn?

A

Potentiate GABA

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12
Q

Triazolam- what does it do to your sleep? what happen to your sleep when you stop taking it?

A

decrease interval to sleep onset, # of intervals of waking = increase total sleep time
-no rebound insomnia!

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13
Q

Triazolam- 3 main categories of side effects

A
  1. CNS
  2. Cardiovascular
  3. Respiratory
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14
Q

What will Triazolam do to your CNS? Which of those side effects will improve?

A

-sedation, confusion, anterograde amnesia, drowsiness, sleep-driving
(sedation and psychomotor slowing improve in 2 weeks)

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15
Q

Oral vs IV Triazolam effects on your CV system… how do we give it iv?

A

Oral – little to no effect on heart and vessels
IV – profound HYPOTENSION and CARDIAC ARREST
= give slowly, port closest to IV

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16
Q

Oral vs IV Triazolam effects on respiratory

A
  • Oral – little to no effect
  • IV: resp depression (esp if taken w/ other CNS depressant)

-Can worsen airway obstruction in OSA or COPD

17
Q

are we giving Triazolam to a preggo?

A

no no

18
Q

considerations for stopping Triazolam

A
  • Physical dependence–>wean the drug slowly

- Withdrawal syndrome: If on high doses can be severe (panic, paranoia, delirium, HTN, muscle twitches, convulsions)

19
Q

what is flumazenil (Romazicon)?

how do we give it?

A

antidote for triazolam

  • Admin/ Duration: over 15 seconds. Repeat Q min.
  • ->Effects last 1 hour.
20
Q

what does flumazenil (Romazicon) do yo resp. depression?

A

NOTHING. it only reverses the sedation aspect of overdose on triazolam

21
Q

prototype for hypnotic benzodiazepine like drug?

A

zolpidem (Ambien)

22
Q

how does zolpidem (Ambien) fxn?

A

Act as agonists at the benzodiazepine receptor site on the GABA receptor-chloride channel

23
Q

side effects of zolpidem?

A
  • sleep driving

- daytime drowsiness/dizziness (most common)

24
Q

Is zolpidem a scheduled drug?

A

Class IV, fool

25
Q

What is good about zolpidem?

A

-no tolerance or physical dependence–>-no rebound insomnia when stopped, no wean off

26
Q

3 classes of drugs to treat anxiety

A

1.Selective Serotonin Reuptake Inhibitors (SSRI)
Discussed later in semester

2.Benzodiazepines
Prototype: diazepam (Valium)

3.Non-Benzo; Non-Barbituates
Prototype: buspirone (BuSpar)

4.dogs

27
Q

prototype for benzo for anxiety is

A

diazepam (Valium)

I am ANXIOUS every DIA of nursing school

28
Q

prototypes for Non-Benzo; Non-Barbituates for anxiety

A

buspirone (BuSpar)

Hydroxyzine

29
Q

admin and onset of buspirone (BuSpar)

A
  • Weeks before peak response

- Not for PRN use

30
Q

considerations that make us like buspirone (BuSpar)

A
  • Not a CNS depressant
  • No abuse potential
  • No suicide risk
  • No increased CNS effects with other drugs (ETOH, benzos, etc.)
31
Q

1 thing that makes us sad about buspirone (BuSpar)

A

no grapefruit

32
Q

Hydroxyzine is what special class of drug that is nonbenzo for anxiety

A

antihistamine

33
Q

Hydroxyzine is different in admin then buspirone. how?

A

Hydroxyzine can be taken PRN or QID

34
Q

Prolonged QT interval with which drug long term?

A

hydroxyzine

35
Q

side effects of hydroxyzine

A

dry mouth, constipation, confusion, dizziness, headache, fatigue

36
Q

is hydroxyzine a scheduled drug?

A

no!

37
Q

does hydroxyzine have withdrawal?

A

no!

38
Q

is hydroxyzine for anxiety only?

A

No!

anxiety+ insomnia

39
Q

s/s of triazolam withdrawal

A

(panic, paranoia, delirium, HTN, muscle twitches, convulsions)

Kol- Pharm 323 Spring (41 decks)

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