CNS Units ABC

Question 1

Benzodiazepine with short half life but slow onset

Answer 1

Lorazepam (Ativan)

Question 2

Benzodiazepine with long half life - works quickly

Answer 2

Diazepam (Valium)

Question 3

Benzodiazepine with moderate half life and quick onset

Answer 3

Alprazolam

Question 4

What benzos have highest abuse potential?

Answer 4

Ones with the quickest onset -
Xanax (alprazolam)
Valium (diazepam)

Question 5

Drugs that cannot be combined with benzos

Answer 5

opioids

Question 6

MOA of benzidiazepines

Answer 6

Enhance responses to GABA

Question 7

SNRIs

Answer 7

Venlafaxine (Effexor)

Duloxetine (cymbalta)

Question 8

First line treatment for depression

Answer 8

SSRIs

Question 9

First line treatment for acute anxiety

Answer 9

benzodiazepines - BUT not for chronic anxiety

Question 10

SSRIs

Answer 10

escitalopram (Lexapro)
Paroxetine (Paxil)
Citalopram (Celexa)
Fluoxetine (Proazac)
Sertraline (Zoloft)

Question 11

BBW for SSRIs

Answer 11

May increase SI, especially in children/adolescents

Question 12

MOA of SSRIs

Answer 12

Block reuptake of serotonin

Question 13

symptoms of serotonin syndrome

Answer 13

confusion, agitation, clonus, fever, tremor, hyperreflexia.

Question 14

SSRIs that are safe in pregnancy

Answer 14

Zoloft

Question 15

Is buspar safe in pregnancy?

Answer 15

yes

Question 16

sleep medication safe for pregnancy

Answer 16

melatonin

Question 17

Anxiolytic

Answer 17

Buspar (buspirone)

Question 18

Drug to drug interactions with Buspar

Answer 18

erythromycin, ketoconazole and grapefruit juice all increase levels of buspar.

Question 19

MOA of buspar

Answer 19

Not a CNS depressant - MOA unknown

Question 20

Benefits of buspar

Answer 20

No abuse

No sedation

Question 21

disadvantages of buspar

Answer 21

takes at least a week for initial response and several more weeks for full effects.

Question 22

Beta blocker used for performance anxiety

Answer 22

Propranolol (Inderal)

Question 23

why does St. Johns wort have so many D2D interactions?

Answer 23

It induces 450CYP3A4

INDUCER - increases other drugs time in body

Question 24

Risk of severe phototoxic skin reactions

Answer 24

St. John’s wort

Question 25

Sedative benzodiazepines

Answer 25

Estazolam (ProSom)
temazepam (Restoril)
Flurazepam (Dalmane)

Question 26

Safety for sedative benzos

Answer 26

short-term only (10 days)
wean slowly
Not for elderly

Question 27

Non-benzo sedatives

Answer 27

eszopiclone (Lunesta)
zaleplon (Sonata)
zolpidem (Ambien)

Question 28

Only sedative for long-term use

Answer 28

Lunesta

Question 29

melatonin agonist - not for pregnancy

Answer 29

Ramelton (Rozerem)

Question 30

Non-benzos pregnancy category C for anxiety or insomnia in pregnancy

Answer 30

Vistaril (Hydroxyzine)

Ambien (Zolpidem)

Question 31

MOA of TCAs

Answer 31

Block reuptake of norepinephrine and serotonin

Question 32

Common TCAs

Answer 32

amitriptyline

Imipramine

Question 33

disadvanges/safety concerns for TCAs

Answer 33

Anticholinergic side effects -
Do not use with elderly or those with CV disease
Lethal with overdose

Question 34

Advantages of TCAs

Answer 34

May help with pain and sleep

Question 35

Atypical antidepressant

Answer 35

Bupropion (Wellbutrin)

Triazolopyridine (Trazodone)

Question 36

Bupropion MOA

Answer 36

norepinephrine-dopamine reuptake inhibitor (NDRI)

boosts NE and Dopamine

Question 37

what makes wellbutrin unique

Answer 37

It can be stimulating/energizing - can help with focus, libido, and motivation

Question 38

Can bupropion be combined with an SSRI

Answer 38

yes - can be beneficial to reduce SE of SSRIs

Question 39

Caution with bupropion (wellbutrin)

Answer 39

May increase seizures