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Advanced Pharmacology > CNS > Flashcards

CNS Flashcards

1
Q

neurotransmitter that causes whole brain arousal, stimulates appetite, and is the neurotransmitter in reinforcement pathways.

A

Norepinephrine

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2
Q

The most basic neurotransmitter involved in primitive functions that affects biologic drives like sex and anger/rage, coordinates movement, and is also the primary neurotransmitter involved in emotion and reinforcement pathways. There are at least 5 different receptors for this neurotransmitter that, when stimulated, elicit different effects.

A

Dopamine

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3
Q

The most ubiquitous neurotransmitter in the body that assists with all parasympathetic nerves. In the brain, it plays a major role in attention, learning, and memory. Alzheimer’s disease is a result of degeneration of these neurons.

A

Acetylcholine (Ach)

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4
Q

neurotransmitter is involved with sleep/wake cycles, mood, chronic pain, and hunger. There are more than 20 different receptors for this one

A

Serotonin (5-hydroxytryptamine or 5-HTseries)

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5
Q

neurotransmitter that inhibits transmission from one nerve to the next in the CNS

A

Gamma-amino butyric acid (GABA)

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6
Q

Anxiety, panic, anorexia, excitability, insomnia

A

Norepinephrine

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7
Q

too much __________= Psychoses, Tourette’s Syndrome

A

Dopamine

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8
Q

too much _________= Delirium/confusion

A

Acetylcholine (Ach)

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9
Q

too much ___________= Sleep-hallucinations

A

Serotonin (5-hydroxytryptamine or 5-HTseries)

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10
Q

too much ___________= CNS depression, Respiratory depression, Sedation

A

Gamma-amino butyric acid (GABA)

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11
Q

too little ____________=Depression, ADD, or ADHD

A

Norepinephrine

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12
Q

too little ____________=Parkinson’s Disease, ADD, or ADHD

A

Dopamine

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13
Q

too little ____________=Alzheimer’s

A

Acetylcholine (Ach)

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14
Q

too little ____________=Depression-OCD, Increased pain sensitivity, Anxiety

A

Serotonin (5-hydroxytryptamine or 5-HTseries)

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15
Q

too little ____________=Seizures

A

Gamma-amino butyric acid (GABA)

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16
Q

Drugs that affect ___________:

SNRIs, Tricyclic Anti-depressants, MAOIs

A

Norepinephrine

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17
Q

Drugs that affect ___________:

Antipsychotics

A

Dopamine

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18
Q

Drugs that affect ___________:

ACHEIs

A

Acetylcholine (Ach)

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19
Q

Drugs that affect ___________:

SSRIs, SNRIs, Atypicals, TCAs, MAOIs

A

Serotonin 5-hydroxytryptamine or 5-HTseries)

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20
Q

Drugs that affect ___________:

Benzodiazepines, Sedatives, Hypnotics

A

Gamma-amino butyric acid (GABA)

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21
Q

an activating neurotransmitter associated with learning, thought, and emotion

A

Glutamate

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22
Q

neurotransmitter that provides relief from pain and promotes feelings of pleasure/well-being.

A

Endorphins

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23
Q

GAD is treated with:

A

Benzodiazepines, SSRI, Buspirone, psychotherapy

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24
Q

Acute (Situational) Anxiety is treated with:

A

Benzodiazepines, antihistamines

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25
Q

Panic Disorder (PD) is treated with:

A

Benzodiazepines, SSRI

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26
Q 
Medications for \_\_\_\_\_\_\_\_\_:
Paroxetine (Paxil)
duloxetine (Cymbalta)
escitalopram (Lexapro)
venlafaxine (Effexor)
A

GAD

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27
Q

Medications for ________:
Hydroxyzine (Atarax, Vistaril)
Propranolol (Inderal®)
Atenolol (Tenormin®)

A

Acute (Situational) Anxiety

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28
Q 
Medications for \_\_\_\_\_\_\_\_\_:
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertaline (Zoloft)
Venlafaxine (Effexor)
A

Panic Disorder (PD)

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29
Q

MOA of ____________:
act by boosting the effect of the neurotransmitter GABA which results in a fast onset of sedation and anxiolytic effect / also work as an anti-convulsant and muscle relaxant

A

Benzodiazepines

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30
Q

Benzodiazeines treat anxiety and ____________

A

seizure disorders

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31
Q

Benzodiazepines are Schedule ___ drugs

A

IV

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32
Q

Benzodiazepines have low potential for abuse when used ___________

A

short-term

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33
Q

The combination of ________ and benzodiazepines can lead to severe respiratory depression and death!!!!

A

opioids

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34
Q

routine daily use of Benzodiazepines may lead to _______________ and is highly discouraged

A

physical dependence

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35
Q

As a cautious prescriber, even if you state the patient could take Benzodiazepines up to _____ PRN severe anxiety, prescribe no more than ___ tablets with no refills

A

TID; 30

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36
Q

a patient who has chronically used benzodiazepines, abrupt discontinuation can cause _________; therefore, discontinuation should be gradually tapered over many weeks.

A

seizures

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37
Q

benzodiazepines are often used for immediate relief from an acute anxiety attack until a safer anxiolytic agent (______ or ________) can take effect and/or resolve insomnia

A

SSRI/SNRI or Buspirone

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38
Q

benzodiazepines with ________ onset of action are associated with the highest potential for abuse.

A

fastest

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39
Q

Benzodiazepines are metabolized in the ______

A

liver

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40
Q

Caution with ___________ food and drugs with benzodiazepines

A

CYP450

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41
Q 
In the CNS, this drug causes:
Sedation
Decreased anxiety
Muscle relaxation
Anti-convulsant action
A

Benzodiazepines

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42
Q

benzodiazepine with a fairly long half-life that effectively treats spasms and decreases seizure activity

A

Diazepam (Valium)

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43
Q

benzodiazepine with a moderate half-life that acts immediately to resolve symptoms– so it is the most addictive

A

Alprazolam (Xanax)

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44
Q

benzodiazepine with slower onset and shorter half-life commonly used for anxiety

A

Lorazepam (Ativan)

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45
Q 
Commonly treated with \_\_\_\_\_\_\_\_\_\_\_\_:
Post-traumatic stress disorder (PTSD)
Obsessive-compulsive disorders (OCD)
Panic attacks
Social anxiety
A

Selective Serotonin Reuptake Inhibitor (SSRI)

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46
Q

For patient with severe anxiety, Rx __-week course of an intermediate-acting benzodiazepine PRN Q 8 hrs. to provide relief until an SSRI/SNRI can take effect.

A

2

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47
Q

Safety Concerns for ___________:
not for long term treatment of anxiety (up to a year)
Levels may be increased by grapefruit juice, erythromycin and ketoconazole

A

Buspirone (BuSpar)

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48
Q 
SE of \_\_\_\_\_\_\_\_\_\_:
dizziness
nausea
headache
drowsiness
A

Buspirone (BuSpar)

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49
Q

anxiety drug that is not habituating and does not have the side effect profile or abuse potential of the benzodiazepines since it is not a CNS depressant

A

Buspirone (BuSpar)

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50
Q

buspirone (Buspar) has a high affinity for _________ receptors and a lesser affinity for __________ receptors

A

serotonin; dopamine

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51
Q

efficacy of this drug is mixed and often the SSRIs that are indicated for anxiety offer better coverage for generalized anxiety disorder (GAD)

A

Buspirone (BuSpar)

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52
Q

strong antihistamine used for anxiety that will cause side effects consistent with antihistamines but in patients with severe anxiety can offer some relief of anxiety

A

Hydroxyzine (Atarax, Vistaril)

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53
Q

if the client has performance anxiety (stage fright), consider using a ___________ 1 hour before event to relieve the catecholamine-mediated autonomic symptoms without sedation

A

beta-blocker (Propanolol)

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54
Q

Ideally, insomnia medications should be given for a ________ duration

A

short

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55
Q

All __________ are indicated for short-term use–10 days maximum. These drugs can cause dependence. Rapid dose decreases of discontinuation can cause withdrawal symptoms.

A

Benzodiazepines

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56
Q

EX of __________:
estazolam (ProSom)
flurazepam (Dalmane)
temazepam (Restoril)

A

Benzodiazepines

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57
Q

Benzodiazepines are not reccommended for the ___________ due to risk of:
falls
fractures
impairment

A

elderly

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58
Q

____________ Drugs:
Eszopiclone (Lunesta)
zaleplon (Sonata)
zolpidem (Ambien, Ambien CR and Intermezzo).

A

Non-Benzodiazepine (“Benzodiazepine-Like”)

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59
Q

___________ is the only Non-Benzodiazepine (“Benzodiazepine-Like”) drug recommended for long-term use (all others are reccomended for max of 35 days)

A

Eszopiclone (Lunesta)

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60
Q

__________ drug:

Ramelton (Rozerem)

A

Melatonin Agonist

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61
Q

OTC 3 or 6 mg. No potential for addiction or tolerance and is inexpensive. It should not be taken with ramelteon (Rozerem).

A

Melatonin Herb

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62
Q

Antidepressants frequently used in treating insomnia in the elderly due to reassuring safety profiles.

A

Mirtazapine (Remeron)

Trazodone (Desyrel)

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63
Q

Due to significant SE, especially in elderly, _____ Antidepressants are rarely used to treat insomnia

A

Tricyclic

64
Q

antihistamines used to treat insomnia (cause anticholinergic effects)
***Caution in:
Depression
Elderly

A

Diphenhydramine (Benadryl)

Hydroxyzine (Vistaril)

65
Q

second-generation antipsychotic that causes sedation but it has multiple side effects and is costly. Avoid off-label use for insomnia.

A

Quetiapine (Seroquel)

66
Q

If a patient suffers from mild depression and has difficulty with sleeping, _______________ is often given before bed due to its sedative effects. This medication produces a moderate blockade of 5HT reuptake. Overdose is less of a risk with this drug than with TCAs.

A

Trazodone (Desyrel)

67
Q

Two drugs that are recommended for chronic insomnia (duration greater than 6 months)

A

Lunesta (eszopiclone) and Rozerem (ramelteon)

68
Q

Patient Teaching for ___________:

  • Do not take unless you have 7-8 hours to sleep
  • Take on an empty stomach at least 30 minutes before bedtime
  • Drugs with long half-lives (eszopiclone) are associated with higher risk of next-day impairment
  • Sleepwalking, sleep driving, sleep eating, sleep sex have been reported with zolpidem and other “Z-drugs”
  • Do not use with other CNS depressants or alcohol
A

Insomnia

69
Q

the best choice for anxiety treatment during pregnancy when a benzodiazepine is indicated and all other alternatives are ineffective

A

clonazepam (Klonopin)

70
Q

a non-benzodiazepine that is used as an anxiolytic that is labeled as pregnancy category B, but use during pregnancy should be avoided due to limited data

A

Buspirone (BuSpar)

71
Q

a non-benzodiazepine that is used as an anxiolytic that is labeled as pregnancy category B, but use during pregnancy should be avoided due to limited data

A

Buspirone (BuSpar)

72
Q

a pregnancy category C non-benzodiazepine that may be used as a last resort, for short-term treatment of insomnia/anxiety in pregnancy

A

Zolpidem (Ambien)

73
Q

benzodiazepines that should be avoided in breastfeeding due to long half-life

A

Diazepam (Valium) and Clonazepam (Klonopin)

74
Q

Short-term use of these anxiolytic drugs with a shorter half-life are likely safe with breastfeeding

A

Midazolam (Versed) and Lorazepam (Ativan)

75
Q

anxiolytic drug that is contraindicated while breastfeeding due to limited data

A

Buspirone (BuSpar)

76
Q

short-term and small-dose use of this anxiolytic drug is likely safe while breastfeeding

A

Hydroxyzine (Vistaril)

77
Q 
Known to cause \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:
Chlorpromazine (Thorazine)
Citalopram (Celexa)
Donepezil (Aricept)
Escitalopram (Lexapro)
Haloperidol (Haldol)
Thioridazine (Mellaril)
A

QT prolongation

78
Q

medications that block the reuptake of norepinephrine, serotonin, and some dopamine from the pre-synaptic neuron, thereby increasing the amount of neurotransmitter in the synapse…different ones block specific combinations of these neurotransmitter receptors in an attempt to refine the effects of the neurotransmitters

A

Antidepressants

79
Q

Once a patient is in remission the antidepressant treatment should be continued for __ to __ months in order to promote complete recovery.

A

6-12

80
Q

first-line most commonly used drugs for depression

A

SSRI and SNRI

81
Q

It will take ___ to ___ weeks to see an initial effect of SSRI and up to ___ weeks to achieve a full effect

A

2-3

6

82
Q

SSRI w/ increased risk of nausea (so reccommend taking them at bedtime)

A

paroxetine (Paxil)

citalopram (Celexa)

83
Q

SSRI w/ increased risk of insomnia (so reccommend taking in the morning)

A

fluoxetine (Prozac)

84
Q

a serious complication that occurs w/ use of serotonergic agents usually as a result of overdose or D2D interactions (especially MAOIs)
Symptoms:
confusion
agitation
clonus
fever
tremor
hyperreflexia
-can result in respiratory failure & death
*resolves w/ discontinuation of the drug
*consider in any patient on these drugs that presents w/ agitation/confucsion

A

serotinin syndrome

85
Q

condition caused by abrupt discontinution of SSRIs
Symtpoms:
dizziness
headache
nausea
sensory disturbances
tremor
anxiety
dysphoria
-begins within days to weeks of the last dose and persist for 1-3 weeks
-resumption of drug will subside symptoms

A

withdrawal syndrome

86
Q 
Contraindications for \_\_\_\_\_\_\_\_\_\_:
Breastfeeding
Patients w/ Sodium depletion
Diuretics
Anticholinergics
A

Lithium

87
Q

Lithium is metabolized in the _________

A

kidneys

88
Q

If hyponatremia occurs while on lithium, this happens

A

lithium reaches toxic levels

89
Q 
Drugs used for \_\_\_\_\_\_\_\_\_:
Lithium
Mood Stabilizers (AEDs)
     -valproic acid (Depakote)
     -Iamotrigine (Lamictal)
     -topiramate (Topamax)
Atypical Antipsychotics
A

Bipolar Disorder

90
Q 
BBW for \_\_\_\_\_\_\_\_\_\_\_\_:
Narrow therapeutic range
Hepatotoxicity
Panreatitis
(children < 6 yo, pt. w/ mitochondrial disorders at higher risk)
A

Lithium

91
Q

condition often caused by long-term use of Lithium

A

hypothyroidism

92
Q

used to treat psychosis, delusions, & bipolar disorder & some have an indication as an adjunct for refractory depression (i.e., aripiprazole (Abilify). The APRN must be familiar w/the many side effects of these drugs & check for D2D interactions for every prescription.

A

Antipsychotics

93
Q

class of meds was the first developed to treat schizophrenia with an MOA of blockage of dopamine-2 (D2) receptors (responsible for movement), which reduced the hyperactivity in the mesolimbic dopamine pathway.

A

1st Generation “Conventional” Antipsychotics

94
Q

SE of _____________:
Negative Extrapyramidal side effects such as tardive dyskinesia (which is sometimes irreversible)
Increase in prolactin levels (hyperprolactinemia) causing galactorrhea, amenorrhea, sexual dysfunction, & weight gain

A

1st Generation “Conventional” Antipsychotics

95
Q

class of meds with MOA of D2 antagonism & serotonin-2A antagonism. The benefits are fewer negative side effects and they help w/ both the negative & positive symptoms of schizophrenia

A

2nd Generation “Atypical” Antipsychotics

96
Q 
SE of \_\_\_\_\_\_\_\_\_\_:
Cardiometabolic risks: 
weight gain
obesity
dyslipidemia
diabetes
accelerated cardiovascular disease.
A

2nd Generation “Atypical” Antipsychotics

97
Q

2nd Gen Atypical Antipsychotics w/ the lowest risk of SE

A

ziprasidone

aripiprazole

98
Q

2nd Gen Atypical Antipsychotics w/ the highest risk of SE

A

clozapine

olanzapine

99
Q 
Indications for \_\_\_\_\_\_\_\_\_\_\_\_\_:
●	Partial Seizures
●	Generalized Tonic-Clonic
●	Bipolar Disorder
●	Trigeminal Neuralgia pain
A

Carbamazepine (Tegretol)

100
Q 
Indications for \_\_\_\_\_\_\_\_\_\_\_\_\_\_:
●	Partial
●	Tonic-Clonic (Grand Mal)
●	Simple
●	Complex
------Prevents seizures after head trauma, 
neurosurgery, &amp; hemorrhagic stroke
A

Phenytoin (Dilantin)

101
Q

Indications for ______________:
● Absence
(Generalized resulting in Petit Mal)

A

Succinimides: Ethosuximide (Zarontin)
Iminostilbenes:
Valproic Acid (Depakote)*
Lamotrigine (Lamictal)*

102
Q

SE of ____________:
Bone Marrow Suppression
SJS in Asians (Check for HLA-B1502 allele prior to starting)

A

Carbamazepine (Tegretol)

103
Q

SE of ___________:

Hepatitis (common hypersensitivity reaction)

A

Phenytoin (Dilantin)

104
Q

these Antiepileptics have fewer SE’s and are the preferred meds for absence seizures

A 
Valproic Acid (Depakote)
Lamotrigine (Lamictal)
105
Q

SE of ____________:

SJS (titrate slowly!)

A

Succinimides: Ethosuximide (Zarontin)
Iminostilbenes:
Valproic Acid (Depakote)*
Lamotrigine (Lamictal)*

106
Q

D2D Interactions of ____________:
Oral contraceptives
Folic Acid

A

Carbamazepine (Tegretol)

107
Q

D2D Interactions of ____________:

may reduce the therapeutic effect of Progestin and Estrogen contraceptives

A

Phenytoin (Dilantin)

108
Q

drug used in combination w/ other anticonvulsants.

A

Valproic Acid (Depakote)

109
Q

anticonvulsant safe in pregnancy but it interacts w/ folic acid so educate patient to take 4 mg Folic Acid daily

A

Carbamazepine (Tegretol)

110
Q

BBW for _____________:
Hypotension
Severe cardiac dysrhythmias
can occur with rapid IV infusion

A

Phenytoin (Dilantin)

111
Q 
BBW for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_:
Contraindicated in:
Sinus Bradycardia
SA Block
2nd and 3rd degree AV block
Stokes-Adams Syndrome
Pregnancy category D
A

Phenytoin (Dilantin)

112
Q

Safety for _____________:
Obtain platelet counts before initiating therapy and at regular intervals
Monitor for bleeding or bruises

A

Valproic Acid (Depakote)

113
Q

Most __________ drugs ARE lipophilic

A

antiepileptic

114
Q

AAP considers ethosuximide, carbamazepine, phenytoin, & valproic acid to be compatible w/ ____________

A

breastfeeding

115
Q

_____________ (anticonvulsant) is associated w/ numerous adverse neonatal effects & should only be used while breastfeeding if there are no alternatives

A

Lamotrigine (Lamictal)

116
Q

Breastmilk levels of ___________ (anticonvulsants) are the lowest of the group. However, _______________ may be associated w/ infant hepatotoxicity & thrombocytopenia, so infants must be monitored accordingly.

A

phenytoin & valproic acid

valproic acid

117
Q

For all ___________ drugs while breastfeeding, the infant should be monitored for jaundice, drowsiness & sedation, appropriate weight gain, & appropriate mental & behavioral development.

A

antiepileptic

118
Q

____________ are used for seizures and as mood stabilizers.

A

antiepileptics

119
Q

antiepileptic used in adults and children

A

Carbamazepine (Tegretol)

120
Q

menopausal women may need ________ supplementation while taking antiepileptic drugs

A

Calcium

121
Q

Ideal contraceptive methods while patient is taking ______________ are progestin-only contraceptives (such as progestin-only pills or progestin-based injections, implants or IUDs), in combination w/ a barrier method.

A

antiepileptics

122
Q

_____________ is commonly used for contraception during antiepileptic therapy… should be given w/in the shortest time interval possible (every ten weeks as opposed to twelve weeks).

A

medroxyprogesterone (DMPA) injection

123
Q

___________ not only alters the metabolism of combined oral contraceptives (COCs) but its metabolism is altered by COCs.

A

Lamotrigine (Lamictal)

124
Q 
\_\_\_\_\_\_\_\_\_\_\_ effects:
dry mouth
urinary hesitancy
tachycardia
constipation
blurred vision
A

Anticholinergic

125
Q

Drugs that cause ____________:
Sedatives/Hypnotics
Tricyclic Antidepressants

A

Anticholinergic Effects

126
Q

drugs that cause EPS, akathisia, and tardive dyskinesia

A

Conventional Antipsychotics

127
Q

ubiquitous/abundant/common neurotransmitter in the body responsible for memory formation
○ Excitatory neurotransmitter for all parasympathetic nerves.
○ In the brain, it plays a major role in attention, learning, & memory formation in the hippocampus
○ Plays role in regulating REM sleep.
○ Alzheimer’s is a result of degeneration of cholinergic neurons.
Too much: Delirium/Confusion
Too little: Alzheimer’s

A

Acetylcholine (Ach)

128
Q

an excitatory neurotransmitter causing cell death

○ Over excitation is cytotoxic

A

Glutamate

129
Q

Neurotransmitters involved in Alzheimer’s

A

Acetylcholine (Ach) and Glutamate

130
Q

____________ Drugs:
donepezil (Aricept), rivastigmine (Exelon), & galantamine (Razadyne)
○ MOA: Prevents breakdown of acetylcholine
○ Excitatory neurotransmitter
○ Involved in learning & memory formation in hippocampus
○ Also, a role in regulating REM sleep cycles (Stahl, 2011)
○ Major SE: GI related - Weight loss, N/V/D, dizziness, muscle cramps, may increase seizure risk (rare)
○ Precautions: bradycardia, conduction defects, asthma, COPD
○ Drug Interactions:
anticholinergics- reduce effectiveness
NSAIDs- increase risk of GI bleed
antifungals- inhibit metabolism, increasing levels

A

Cholinesterase Inhibitors (mild to moderate Alzheimer’s)

131
Q

______________ Drugs:
○ MOA: Blocks excessive excitation of NMDA receptors by glutamate as over excitation by glutamate is cytotoxic.
○ Plays a role in cognition, memory, learning.
○ Major side effects include dizziness, HA, constipation
○ Use cautiously in pts w/ renal impairment
○ Drug Interactions:drugs that raise urine pH (causes elevated levels)
other NMDA antagonists (amantadine, ketamine, & dextromethorphan)

A

N-methyl-D-aspartic acid (NMDA) Receptor Antagonist (moderate to severe Alzheimer’s)

132
Q

First line ADHD drugs:
○ Methylphenidate
○ Dextroamphetamine
Slow-dose & pulsatile drugs that amplify (NE) norepinephrine & (DA) dopamine signals that are low. Studies do not demonstrate a difference in efficacy among these drugs

A

Stimulants

133
Q

these antidepressants are contraindicated in the elderly

A

TCAs and MAOIs

134
Q

Due to decreased renal clearance, reduced hepatic function and frequently reduced albumin levels, the dose of ____________ is started at one-third to one-half of the usual starting adult dosage in the elderly

A

SSRIs and SNRIs

135
Q

these drugs are frequently used in treating insomnia in the elderly d/t reassuring safety profiles

A

Mirtazapine (Remeron) and Trazodone (Desyrel)

136
Q

this atypical antidepressant is often given at bedtime to elderly patients with insomnia and weight loss as it stimulates appetite, is sedating and exerts an antidepressant effect

A

Mirtazapine (Remeron)

137
Q

vast majority of benzos are contraindicated in ________ except in rare instances where benefits outweigh the risk

A

pregnancy

138
Q

conflicting studies surround _________ use in pregnancy…some studies show:
oral cleft
preterm labor
fetal growth restriction
“Floppy baby syndrome” (lack of tone, sluggishness, & difficulty w/ the sucking reflex) immediately after birth & newborn withdrawal up to three months

A

benzo

139
Q

Short-term use of these benzos w/ a shorter half-life is likely safe w/ breastfeeding.

A

Midazolam (Versed) & Lorazepam (Ativan)

140
Q

avoid these benzos w/ longer half-life in breastfeeding

A

Diazepam (Valium) & Clonazepam (Klonopin)

141
Q

When all alternatives are ineffective, and a Benzo is indicated in pregnancy, short-term use of ____________ is the safest option

A

clonazepam (Klonopin)

142
Q

While it is labeled as pregnancy Cat B, this non-benzo during pregnancy and breastfeeding should be avoided due to limited data

A

busipirone (BuSpar)

143
Q

non-benzo that is considered safe in breastfeeding due to low breastmilk levels and short half-life

A

zolpidem (Ambien)

144
Q

these durgs are indicated for short-term use ONLY– 10 days max b/c they can cause dependence. Rapid dose decreases or discontinuation can cause w/drawal symptoms, including anxiety & insomnia.

A

Estazolam (ProSom)flu
razepam (Dalmane)
temazepam (Restoril)

145
Q

If a pt suffers from mild depression & has difficulty w/ sleeping, _________ is often given before bed due to its sedative effects. This med produces a moderate blockade of 5HT reuptake. Overdose is less of a risk w/ this drug than w/ TCAs.

A

Trazodone

146
Q

a unique agent that has been used as an aid for smoking cessation called ______.
DO NOT give to anyone who has a history of seizure risk!!!
Benefits: less sexual dysfunctio/ mild weight loss

A

Bupropion/ Zyban

147
Q

When choosing an antidepressant therapy: pts w/ pain may achieve some pain relief w/ the use of these drugs

A

Duloxetine or TCA

148
Q

the most studied antidepressant for use w/ children and is the only antidepressant recommended for use in children 8 yrs & above

A

fluoxetine (Prozac)

149
Q

these drugs are first-line choice for breastfeeding mothers with PPD due to their low excretion into breastmilk

A

SSRIs:
sertraline (Zoloft)
paroxetine (Paxil)
fluvoxamine (Fluvox)

150
Q

this drug is NOT first line for breastfeeding mothers w/ PPD

A

fluoxetine (Prozac)

151
Q

this drug for bipolar disorder to contraindicated in pregnancy (Cat D) due to risk of CV defects so it may be temporarily discontinued until postpartum

A

Lithium

152
Q

most significant SE that should be monitored during Atypical Antipsychotic therapy

A

cardiometabolic risks (weight gain, obesity, dyslipidemia, diabetes, accelerated cardiovascular disease)

153
Q 
Major SE of \_\_\_\_\_\_\_\_\_\_\_:
GI related:  Weight loss, N/V/D
izziness
muscle cramps
may increase seizure risk (rare)
A

Cholinesterase Inhibitors

154
Q

a woman w/ a history of birthing a child w/ a neural tube defect (NTD) or Diabetic woman, supplementation of _______should increase to ten times the daily recommended amount for pregnancy, to 4 mg/day for 3 months prior to conception

A

B9 and Folic Acid

155
Q 
Potential interactions of \_\_\_\_\_\_\_\_\_\_\_\_\_:
SSRIs (really, all antidepressants)
Triptans
Benzos
Contraceptives
some ABXs
Digoxin.
A

St. Johns Wort

156
Q

1 hourr of __________ is equivalent to 3 hrs of sleep. However, it is not recommended instead of sleep, but rather in addition to sleep.

A

Yoga Nidra

157
Q 
CNS Drugs that \_\_\_\_\_\_\_\_\_\_\_\_\_:
Chlorpromazine
Citalopram
Donepezil
Escitalopram
Haloperidol
Thioridazine
Trazodone
A

prolong QT interval

Advanced Pharmacology (8 decks)

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