Anxiolytics/Lithium Flashcards
is tolerance and abuse an issue for prescribed benzodiazepines
no
what are the relative contraindications to use of benzodiazepines for treatment of anxiety
hx of alcohol abuse or substance abuse
for situational anxiety or generalized anxiety includes what drug and dose is used to minimize sedation?
- how long does sedation usually last
diazepam 2-5mg TID
last around 2 weeks
what group of individuals experience greater sedation and greater impairment of psychomotor performance when taking benzodiazepines
elderly patients
this drug is a nonbenzodiapexpine effective in the treatment of generalized anxiety disorder
buspirone
MOA of buspirone
partial agonist at serotonin receptors resulting in decreased serotonin turnover
what is the principle disadvantage of buspirone
slow onset of effect 1-2 weeks. which may be interpreted as ineffectiveness by patients experiencing anxiety
____ anticonvulsants and antipsychotics are considered drugs of choice for the treatment of bipolar disorder
lithium
Lithium MOA
inhibits second messenger system leading to release of calcium ions from intracellular storage sites- repeated firing causes the neuron to be depleted of second messenger
what is the plasma lithium concentrations goal
1.0-1.2mEq/L
when do we draw lithium levels
10-12 hrs after last dose
after a lithium dose change when should levels be rechecked
4-5 days
the most common serious side effects of lithium
polydipsia and polyuria
which diuretics facilitate the excretion of lithium
potassium sparing triamtere, spironolactone
which diuretics facilitate increased plasmas concentrations
loop and thiazide
NSAIDS can do what to lithium concentrations
decrease renal blood flow and may produce marked increases in plasma concentration of lithium
This certain potassium sparing diuretic is effective in deceasing urine volume without affecting the plasma concentrations of either lithium or potassium
amiloride
if a patient is on lithium how often do we check BUN and CR
every 6months
patient with sick sinus syndrome should have what in place prior to lithium therapy
artificial cardiac pacemaker in place
this side effect of lithium therapy is more common in women than men develop around 5% of the time
hypothyroidism
what is the response to depolarizing and non depolarizing drugs while on lithium
prolonged in the presence of lithium as well as anesthetics
what is the effect of ACE inhibitors to lithium concentrations
may increase plasma lithium concentrations
why are beta blockers used during lithium therapy
decrease lithium induced tremor
valporic acid off label use
migraine
