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Phase 2 - Psych > Drugs > Flashcards

Drugs Flashcards

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1
Q

Sedative is?

A

Anxiolytic- exerts a calming effect - w/ no efx on motor/mental fix

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2
Q

Hypnotic is?

A

Produces drowsiness for sleep

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3
Q

2 Major classes of sedatives?

A

Benzodiazepines and barbiturates

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4
Q

Benzodiazepines are used for? Barbiturates used for historically?

A

Short term sedation, insomnia, epilepsy, anesthesia

Insomnia/epilepsy/anesthesia

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5
Q

MOA of sedatives/hypnotics?

A

Binds to GABA receptors; increases Cl- influx

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6
Q

Which dose curve is more dangerous? Barbs or Benzo?

A

Barbiturates - coma, death faster

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7
Q

Barbiturates are metabolized where?

A

Liver

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8
Q

Most severe adverse SEs of barbiturates?

A

CNS depression
Hangover effect
Withdrawal (more severe than opiates)

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9
Q

What pregnancy category is barbiturates?

A

Cat D

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10
Q

Treatment of Barbiturate overdose?

A

Ventilation
Stomach purge
+- hemodialysis

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11
Q

Specific SEs of phenobarbital?

A

Sex dysfx
HOTN, Brady-C
Hyperactivity w/ cognitive impairment

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12
Q

Short acting (t1/2) BZDs?

A

Midazolam
Oxazepam
Triazolam

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13
Q

Intermediate t1/2 BZDs?

A

Alprazolam
Estazolam
Lorazepam
Temazepam

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14
Q

Long acting t1/2 BZDs?

A 
Chloridazepoxide
Clonazepam
Diazepam
Flurazepam
Quazepam
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15
Q

Short vs Long t1/2 BZDs SEs?

A

Long -
last all day,
less withdrawal, breakthrough s/s
more hangover s/s

Short -
Better/quicker control for acute mgmt
Tolerance is rapid
Withdrawal/breakthrough s/s is common

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16
Q

BZDs will not have what effects/actions?

A

No analgesic
No antipsychotic
No efx on ANS

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17
Q

Best BZDs for Etoh Withdrawal?

A

Oxazepam (liver disease)
Lorazepam (liver disease
Chlordiazepoxide (Long acting coverage)
Diazepam (Long acting coverage)

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18
Q

Best long acting/fast onset BZD?

A

Diazepam

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19
Q

BZDs used for Anxiety?

A
  1. Lorazepam
  2. Diazepam
  3. Clonazepam (Not FDA approved)
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20
Q

Short term BZDs have more of a risk of?

A

Withdrawal

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21
Q

BZDs used for Panic attack?

A

Clonzepam
Alprazolam
Oxazepam

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22
Q

Short acting BZDs for insomnia

A

Triamzolam

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23
Q

Intermediate acting BZDs for sleep maintenance?

A

Temazepam

Estazolam

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24
Q

Which BZDs has the fastest onset?

A

Lorazepam 2-3m

Diazepam 4-5m

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25
Q

Common adverse SEs of BZDs?

A

Residual daytime sedation
Rebound insomnia
Antegrade amnesia

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26
Q

What is max TXT period for BZDs?

A

3-4mo

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27
Q

BZD pregnancy category?

A

Cat D to X

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28
Q

BZDs for geriatrics?

A

Lorazepam
Oxazepam
Temazepam

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29
Q

Rescue/reversal agent for BZDs? How is it administered?

A

Flumazenil (IV) possible to have multiple doses due to quick onset/duration

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30
Q

NON-Benzodiazepines

A 
Buspirone (buspar)
Zolpidem (Ambien)
Eszopiclone (Lunesta)
Zaleplon (Sonata)
Ra-melteon
Tasi-melteon
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31
Q

Name drugs w/ MOA - melatonin receptor agonist?

A

Ra-melteon

Tasi-melteon (blindness)

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32
Q

Busprione MOA?

A

Sero/D2 receptors action

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33
Q

Buspirone vs BZDs?

A

Buspirone has no abuse potential, sedation, or euphoric effects.

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34
Q

Buspirone is typically used for?

A

Mgmt of anxiety disorders

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35
Q

Non-BZDs, Non melatonin agonist that are used for insomnia?

A

Zolpidem (Ambien)
Eszopiclone (Lunesta)
Zaleplon (sonata)

36
Q

Insomnia Rx similar SE’s

A 
SI, ABNL behavior change
Fx dependence(Not physical dependence)
37
Q

Unique SE of Eszopiclone (Lunesta)?

A

Metallic taste

38
Q

Sedating antidepressants?

A

Mirtazapine
Trazadone
Doxepin

39
Q

Sedating AH?

A

Diphenhydramine

Doxylamine

40
Q

SEs of sedating AHs?

A

Anticholinergic effects (Bad BPH/Dementia)

41
Q

Non-BZDs Rx for sleep onset insomnia?

A 
Zolpidem (Ambien)
Eszopiclone (Lunesta)
Zaleplon (sonata)
or
Ra-melteon
42
Q

Non-BZDs Rx for sleep maintenance insomnia?

A

Eszopiclone (Lunesta)

Zolpidem (Ambien)

43
Q

Acute mgmt of anxiety d/o or panic attack?

A

BZDs (as adjunct w/ antidepressants)

44
Q

GAD Rx mgmt? 1L and others

A

SSRI > SNRI > TCAs

Adjuncts - Buspirone and pregabalin

45
Q

Refractory GAD txt?

A

Antipsychotic (Quetiapine)

46
Q

Panic d/o Rx mgmt? 1L and others

A

SSRI > SNRI > TCAs > MAOI

Adjuncts - 1L Clonazepam or Alprazolam

47
Q

Social anxiety d/o Rx mgmt? 1L group and others (2L, performance anxiety)

A

SSRI > SNRI > TCAs > MAOI
(Adjuncts - 1L Clonazepam or Alprazolam)

2L agents - gabapentin or pregbalin

Performance anxiety - propanolol

48
Q

OCD Rx mgmt? 1L and others

A

SSRI > SNRI > TCAs

Adjunct antipsychotics

49
Q

Rx used for nightmares?

A

Prazosin

50
Q

PTSD Rx mgmt? 1L and others

A 
SSRI or SNRIs
(Adjunct or mono-T antipsychotics)
- Quetiapine
- Olanzapine
- Risperidone
(Nightmares - prazosin alpha-blk)
(Uncontrolled anxiety - BZDs)
(Impulsive behavior - anticonvulsants)
51
Q

Anticonvulsants used for impurlsive behavior w/ PTSD?

A

Tiagabine
Topiramate
Divalproex

52
Q

Binge drinking is?

A

0.08g/dL <2hrs

53
Q

Mild symptoms of ETOH Withdrawal begin when?

A

w/in 6hrs after last drink

54
Q

Delirium Tremens may occur when?

A

1-5d after last drink

55
Q

1L seizure prevention in ETOH withdrawal?

A

BZDs

  1. Lorazepam (best for liver)
  2. Diazepam
  3. Chlordiazepoxide
56
Q

Chronic ETOH abuse is associated w/ what neurologic condition?

A

Wernickes encephalopathy

57
Q

Wernickes encephalopathy triad?

A

Confusion, ataxia, ophthalmoplegia

58
Q

TXT of malnutrition in ETOH abuse?

A

Thiamine/folic acid/b12 (Vitamins) + lytes + fluid

59
Q

TXT of etoh dependence?

A

1L - Naltrexone or Acamprosate

60
Q

Naltrexone MOA?

A

Competitive agonist at opioid receptors reducing alcohol dependence

61
Q

Acamprosate MOA?

A

GABA action and Antagonism of glutamate

62
Q

Acamprosate use?

A

Maintain ETOH abstinence (x3D)

63
Q

Main Difference between Naltrexone and Acamprosate

A

Naltrexone is metabolized by Liver (x5)

Acamprosate is excreted by kidneys

64
Q

Requirments before initiating ADHD medications?

A

Vitals (BP, HR, ht/wgt)

65
Q

Stimulant medications used for ADHD?

A

Amphetamines
Dextroamphetamine
(Dex) Methylphenidate
Lisdexamfetamine

66
Q

Non-stimulant medication for ADHD?

A

Atomoxetine
Clonidine
Guanfacine

67
Q

MOA is amphetamine stimulants?

A

Release NEPI/DOPA

68
Q

Amphetamine stimulant uses?

A

ADHD
Narcolepsy
Obesity

69
Q

Amphetamine stimulants are CI in what pts?

A

HTN, CV disease, Hyperthyoridism, Glaucoma

70
Q

Two main types of stimulants for ADHD?

A

Amphetamines

Methylphenidate (Dexmethylphenidate)

71
Q

Methylphenidate brand names?

A

Ritalin or Concerta

72
Q

Dexmethylphenidate brand name?

A

Focalin

73
Q

Non-stimulants Rx for ADHD are perferred if?

A

Concern for abuse
Pt preference
CI medical conditions

74
Q

MOA of atomoxetine?

A

Blocks reuptake of NEPI (non-stimulant)

75
Q

MOA of clonidine XR?

A

Central alpha2 agonist

76
Q

Clonidine/Guanfacine uses?

A

PEDs - intolerant to stimulants/TICs

77
Q

Clonidine SEs?

A

HOTN, Brady-C

Arrythmias - QTC-Prolongation

78
Q

MOA of Guanfacine XR?

A

Central alpha2 agonist

79
Q

Central alpha2 agonist RXs?

A

Clonidine

Guanfacine

80
Q

Are SSRIs useful in ADHD?

A

No

81
Q

TCAs used in ADHD?

A

Imipramine

Desipramine

82
Q

Other stimulant Rx (separate from ADHD Dx)?

A

Modafinil

Armodafinil

83
Q

Uses of Modafinil and Armodafinil?

A

OSA - excess sleepiness
Narcolepsy
Shift work disorder

84
Q

Caffeine is AKA?

A

Methylxanthine

85
Q

Which Antidepressants suppress appetite?

A

SSRI - Fluoxetine, Sertraline

Buproprion (wellbutrin)

Phase 2 - Psych (7 decks)

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