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Pharmacology - Spring 2024 > Ch. 14 Drugs - Anxiety & Insomnia > Flashcards

Ch. 14 Drugs - Anxiety & Insomnia Flashcards

1
Q

Types of Anxiety Disorders

A

Situational anxiety
Generalized anxiety disorder (GAD)
Panic disorder
Phobias
Social anxiety disorder
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorders (PTSD)

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2
Q

Regions of the brain that are associated with anxiety, expression of emotions, and a restless state.

A

Limbic System & Reticular Formation

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3
Q

Antidepressants for Anxiety & Anxiety-Related Symptoms

A

SSRIs
SNRIs - atypical antidepressants
TCAs
MAOIs

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4
Q

CNS Depressants for Anxiety and Anxiety-Related Symptoms

A

Benzodiazepines
Barbiturates
Other drugs

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5
Q

Nonpharmacologic Therapies for Anxiety and Insomnia

A

Cognitive Behavioral Therapy
Counseling
Biofeedback Techniques
Meditation

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6
Q

Short-term or behavioral insomnia is sometimes attributed to what?

A

Stress

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7
Q

What may disturb sleep?

A

Food or beverages with stimulants

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8
Q

Long-term insomnia is caused by what?

A

Depression
Manic disorders
Chronic pain

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9
Q

this is caused by the discontinuation of long-used sedative drugs

A

Rebound insomnia

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10
Q

Drugs that have the ability to relieve anxiety

A

Anxiolytics (Benzos)

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11
Q

These drugs work by slowing down the neuronal activity in the brain

A

CNS Agents - Antidepressants

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12
Q

4 classes of CNS depressants to treat anxiety and sleep disorders

A

Antidepressants
Benzodiazepines
Nonbenzodiazepines anxiolytics
Barbiturates

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13
Q

A continuum ranging from relaxation, to sedation, to the induction of sleep and anesthesia

A

CNS depression

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14
Q

These drugs treat major depression and a range of anxiety conditions

A

Antidepressants

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15
Q

What are the primary medications to reduce symptoms of panic and anxiety?

A

TCAs
MAOIs
SSRIs
Atypical antidepressants that do not fall conveniently into other categories

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16
Q

The most commonly prescribed antidepressant

A

SSRIs

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17
Q

SSRI prototype drug

A

escitalopram (Lexapro)

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18
Q

Prozac, Celexa, Paxil, & Zoloft

A

Examples of antidepressant drugs

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19
Q

Increases the availability of serotonin at specific postsynaptic receptor sites in the CNS

A

SSRIs MOA

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20
Q

Adverse Effects of SSRIs

A

Weight gain
Sexual dysfunction
Dizziness
Insomnia
Somnolence
Confusion
Seizures

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21
Q

Black Box Warning of SSRIs

A

Increased risk of suicidal ideation and behavior in children

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22
Q

Atypical Antidepressant

A

SNRIs - Selective Norepinephrine Reuptake Inhibitor

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23
Q

Cymbalta, Efecor, trazadone

A

Examples of SNRIs

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24
Q

Abnormal dreams
Sweating
Constipation
Dry mouth
Loss of appetite
Weight loss
Tremors
Abnormal vision
Headaches
Nausea/Vomiting
Dizziness
Loss of sexual desire
Hypertension
Tachycardia

A

Side effects of SNRIs

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25
Q

Black Box warning for SNRIs

A

Increased risk of suicidal ideation

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26
Q

Amitriptyline, Imipramine
Almost all drugs that end with suffix -mine or -line

A

TCAs - Tricyclic Antidepressants or Cyclic Antidepressants

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27
Q

among the first antidepressants developed

A

TCAs

28
Q

Effective for depression resistant to other classes of medication, but have much more serious side effects

A

TCAs

29
Q

TCAs contraindications

A

Heart attack
Heat block
Arrhythmia

30
Q

TCAs pregnancy category

A

C or D

31
Q

Dry mouth
Blurred vision
Urine retention
Hypertension
Angioedema
Agranulocytosis
Bone marrow suppression

A

TCAs side effects

32
Q

Avoid concurrent use of what when taking TCAs

A

Alcohol or other CNS depressants

33
Q

escitalopram (Lexapro)
Prozac
Celexa
Paxil
Zoloft

A

SSRIs drug examples

34
Q

phenelzine

A

MAOI example

35
Q

Patient education for MAOIs

A

Avoid foods containing tyramine - beer, wine, smoked or cured meats, aged cheese, certain type of beans

36
Q

Why should a patient avoid tyramine if taking MAOIs?

A

Can cause hypertensive crisis if ingested while on MAOI

37
Q

What drugs potentiate the effects of insulin and other diabetic drugs?

A

MAOIs

38
Q

Common adverse effects of MAOIs

A

Orthostatic hypotension
Headache
Diarrhea

39
Q

alprazolam (Xanax)
chlordiazepoxide (Librium)
clonazepam (Klonopin)
clorazepate (Tranxene)
diazepam (Valium)
lorazepam (Ativan)
oxazepam (Serax)

A

Benzodiazepines for Anxiety Therapy

40
Q

estazolam
flurazepam
quazepam (Doral)
temazepam (Restoril)
triazolam (Halcion)

A

Benzodiazepines for Insomnia Therapy

41
Q

Benzodiazepine drugs differ in what?

A

Onset and duration. They all have the same MOA and adverse effects

42
Q

Preferred drug for anxiety disorders and insomnia

A

Benzodiazepines

43
Q

Whats the relationship b/w benzodiazepines and insomnia?

A

Used for particularly short term insomnia caused by anxiety

44
Q

Other indications for benzodiazepines

A

Seizure disorders
Alcohol withdrawal
Muscle relaxation
Induction of anesthesia for procedures

45
Q

Why are benzodiazepines used?

A

B/c they are effective while not producing life-threatening respiratory depression

46
Q

Life-threatening respiratory depression of benzodiazepines can occur when?

A

If used in conjunction with other substances-medications, illegal drugs, and alcohol

47
Q

Withdrawal symptoms occur with benzodiazepines when?

A

If stopped abruptly

48
Q

Drugs rarely prescribed due to side effects and dependence

A

Barbiturates

49
Q

Barbiturates are prescribed for what?

A

Sedative, hypnotic, and antiseizure effects

50
Q

Pentobarbital
Phenobarbital
Secobarbital

A

Examples of barbiturates

51
Q

Barbiturates what a high risk for what?

A

Psychological and physical dependence

52
Q

Barbiturates drug class schedule

A

Schedule II drug

53
Q

Barbiturates withdrawal symptoms

A

Severe- potentially fatal

54
Q

Barbiturates have a high risk for what?

A

Overdose & respiratory arrest

55
Q

Side effects of barbiturates

A

Respiratory depression and increased metabolism

56
Q

drugs that are chemically unrelated to either benzodiazepines or barbiturates, but also reduce anxiety

A

Nonbenzodiazepine, Nonbarbiturate CNS Depressants

57
Q

Nonbenzodiazepine, Nonbarbiturate CNS Depressant Drug Prototype

A

zolpidem (Ambien)

58
Q

zolpidem (Ambien) is used mainly for what?

A

Treatment of social anxiety symptoms and insomnia

59
Q

Adverse effects of zolpidem (Ambien) and other Nonbenzodiazepine, Nonbarbiturate CNS Depressants

A

Mild nausea
Dizziness
Diarrhea
Daytime drowsiness
Amnesia
Sleepwalking
Eating while asleep

60
Q

zolpidem (Ambien) MOA

A

binds to GAB receptor
Preserves sleep stage III
Offers minor effects of REM sleep

61
Q

Examples of Nonbenzodiazepine, Nonbarbiturate CNS Depressants

A

zolpidem (Ambien)
buspirone
Precedex
Lunesta

62
Q

Antiseizure med used for social anxiety

A

valproic acid (Depakote)

63
Q

Beta Blockers used for social and performance anxiety

A

atenolol
propanolol

64
Q

Melatonin receptor drug used for insomnia

A

Ramelteon

65
Q

Orexin Receptor Blocker drug used for insomnia and to help maintain sleep throughout the night

A

suvorexant

Pharmacology - Spring 2024 (8 decks)

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