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Vicky's Cards - Exam 1 > First > Flashcards

First Flashcards

1
Q

What are five causes of anxiety?

A 
respiratory
endocrine
cardiovascular
metabolic
neurologic
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2
Q

What are the drugs that can cause anxiety?

A

stimulants
sympathomimetics
anticholinergics/antihistaminergic
dopaminergics

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3
Q

TCA is an example of a drug that can cause ____________

A

anxiety

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4
Q

Meperidine is an __________ derivative

A

opioid

*anticholinergic/antihistaminic

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5
Q

What does baclofen do?

A

relaxes the muscles

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6
Q

Baclofen, cycloserine, hallucinogens and indomethacin can all lead to ____________

A

anxiety

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7
Q

What are narcotics?

A

opioids and their derivatives only

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8
Q

Hypnotics are drugs that enduce ___________

A

sleep

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9
Q

Small doses of hypnotics cause _______

A

sedation

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10
Q

Medium doses of hypnotics cause _________

A

hypnosis

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11
Q

High dises of hypnotics cause ____________

A

surgical anesthesia

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12
Q

What system is primarily depressed by sedatives?

A

respiratory

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13
Q

“situational stress” insomnia is best treated by ___________

A

hypnotics

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14
Q

What is the most commonly prescribed antianxiety drug?

A

benzodiazepines

*b/c of their large therapeutic index

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15
Q

MOA of benzodiazepines

A

enhace neuronal GABA-mediated chloride channels

*increases permeability to chloride

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16
Q

_______________ are positive allosteric modulators of the GABAa receptor

A

benzodiazepines

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17
Q

Once a neuron is hyperpolarized it can no longer _________________

A

depolarize

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18
Q

Chloride causes the cell to________________

A

hyperpolarize

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19
Q

Alpha1 subunit causes _______

A

sedation

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20
Q

Alpha2 subunit causes_________

A

anxiolysis

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21
Q

Alpha3 subunit causes_________

A

processing of sensory motor information related to a schizophrenia endophenotype

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22
Q

Alpha4 subunit causes _________

A

sedation, hypnotic and anesthetic effects

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23
Q

Alpha5 subunit is ______

A

extrasynaptic

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24
Q

Beta3 subunit causes ____________

A

sedation, hynosis and anesthesia
*pentobarbital
propofol
etomitate something

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25
Q

benzodiazepines are ____________

A

anxiolytics

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26
Q

_______________ is the major inhibitory neurotransmitter in the CNS

A

GABA

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27
Q

Benzodiazepines ___________ effect the ANS

A

do not

*does not effect blood pressure

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28
Q

How do benzodiazepines relieve anxiety?

A

through enhacement of the inhibitory activity of GABA

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29
Q

Blood pressure is an indication of your ____________ control

A

autonomic

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30
Q

What benzo is commonnly used to treat panic disorders?

A

alprazolam

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31
Q

What benzo is commonly used to treat muscular spasms?

A

diazepam (fast acting)

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32
Q

What benzo is commonly used to treat seizure disorders and epilepsy?

A

clonazepam

diazepam

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33
Q

What benzos are commonly used to treat conscious sedation insomnia?

A

flurazepam (long acting)
temazepam (intermediate)
triazolam (short)

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34
Q

Benzos are used as an ___________ in pt’s with schizophrenia

A

adjuncts

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35
Q

What is the gold standard for treating a sustained seizure (status epilepticus) ?

A

diazepam

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36
Q

What is the speed of onset of oxazepam?

A

slowest

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37
Q

What is the fastest acting benzodiazepine?

A

diazepam

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38
Q

What benzodiazepam has the longest half life?

A

diazepam

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39
Q

What benzodiazepam has the shortest half life?

A

oxazepam

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40
Q

What benzodiazepam has the slowest speed of onset?

A

oxazepam

41
Q

What benzodiazepams are available in IM form?

A

lorazepam

midazolam

42
Q

What is the onset of action of IV lorazepam?

A

1-5 minutes

43
Q

What is the onset of action of IM lorazepam?

A

15-30 minutes

44
Q

What are possible AE of parenteral administration of benzodiazepines?

A 
apnea
hypotension
bradycardia
cardiac arrest 
*especially in older patients
45
Q

Benzodiazepines are ____________ and rapidly absorbed after oral administration

A

lipophyllic

46
Q

Avoid co administration of lorazepam IM and ___________ d/t reports of related death

A

olanzapine IM

47
Q

Do benzodiazepine cross the placenta?

A

yes

48
Q

_____________ combined with benzodiazepine may cause severe hypotension, respiratory or cardiac arrest, loss of consciousness

A

clozapine

49
Q

Smoking will __________ the effect of benzodiazepines

A

decreased

50
Q

Alcohol will __________ the effect of benzodiazepines

A

increase

51
Q

Antifungals will __________ the effect of benzodiazepines

A

increase (increased plasma concentration)

52
Q

What are the AE of benzodiazepines?

A

CNS depression
disorientation, irritability
impairment of memory and recall
respiratoy depression

53
Q

With what conditions should benzodiazepines be given cautiously?

A

liver disease
glaucoma
alcohol
CNS depression

54
Q

What part of brain is involved in memory formation?

A

hippocampus

55
Q

How do benzodiazepines cause memory impairment?

A

Effect hippocampus

56
Q

Tolerance to benzodiazepines ________ in response to the medication side effects

A

Decreases

57
Q

How is physical dependence to a drug defined?

A

when medication is stopped, withdrawal or discontinuation symptoms occur

58
Q

___________ is a benzo with a high risk of withdrawal d/t the short 1/2 life

A

alprazolam

59
Q

How can you prevent benzodiazepine withdrawal?

A

convert to longer acting agent to taper slowly

60
Q

What is the number one benzodiazepine blocker?

A

flumazenil (IV)

61
Q

MOA of flumazenil

A

binds competitively to benzodiazepine receptors

62
Q

Flumazenil given with what drug may increase the risk of seizures?

A

TCAs and benzodiazepines

63
Q

AE of flumazenil

A

agitation, confusion, sweating, n/v, blurred vision, seizure

64
Q

Buspirone is a ___________ agonist

A

serotonin type 1A receptor

65
Q

What is the risk of dependence to buspirone?

A

very low-none

66
Q

Buspirone is metabolized by ______________

A

liver enzymes

CYP34A

67
Q

Buspirone may increase __________ secretion and growth hormone

A

prolactin

68
Q

Buspirone may cause _ thermia

A

hypo

69
Q

What is a risk of buspirone?

A

Risk of serotonin syndrome when co-administered with an SSRI

70
Q

How does someone with serotonin syndrome present?

A

restlessness, diaphoresis, tremors

abdominal cramps

71
Q

MOA of zolpidem?

A

act on GABA, not an anticonvulsant, no w/d effect

72
Q

Zolpidem is more selective for _________ subunit of benzodiazepine receptor complex

A

alpha- 1

73
Q

Zolpidem is hepatically oxidized by ___________

A

CYT-P450

74
Q

Zaleplon affects ____________ and ___________ functions

A

psychomotor

congnititve

75
Q

Zaleplon is metabolized by the ___________

A

liver

76
Q

What is the 1/2 life of zolpidem?

A

2.5 hours

77
Q

What is hydroxyzine?

A

antihistamine

antiemetic

78
Q

What beta blockers are commonly used to treat stage fright?

A

atenolol

propranolol?

79
Q

What is the indication for alprazalam?

A

panic attack, anxiety, depression

80
Q

Flurazepam has the ___________ half life of the benzos

A

longest

81
Q

What is the effect of most hypnotics on the sleep pattern?

A

decrease onset latency
increase NREM duration
decrease REM duration

82
Q

What is the ultra short acting barbituate?

A

thiopental

83
Q

What are the short-intermediate acting barbituates?

A

pentobarbital, secobarbital, amobarbital

84
Q

What is the long acting barbituate?

A

phenobarbital

85
Q

MOA of barbituates

A

at high concentrations, direcly activate the GABAa receptor to enhacne chloride permeability–in addition to allosteric modulation of the GABAa receptor

86
Q

What are the membrane effects of barbituates?

A

nonspecific neuronal depression has been reported at highly very high (toxic) doses

87
Q

What barbituate is often used for sedation (anesthesia)?

A

thiopental (inducer)

88
Q

What is an unusual use of barbituates?

A

neonatal hyperbilirubinemia and kernicterus

usually manifests the second day

89
Q

When barbituates are excreted in the urine, they are in a ______________ form

A

anionic

90
Q

AE of barbituates

A

hangovers, hyperalgesia, CNS excitation, hypersensitivity

91
Q

What do barbituates do at sub-lethal dose intoxications?

A

ganglionic blockade

hypotension/hypothermia

92
Q

What is a major contraindication to barbituates?

A

acute intermittenet porphyria

93
Q

In a barbituate overdose, what can you give them to alkalinizate their urine?

A

bicarb

94
Q

Why do you want to alkanilize the urine in a barbituate overdose?

A

excreets the drug faster

95
Q

Barbituates are a _________ inducer of cytochrome P450

A

potent

96
Q

What are the sedatives/hypnotics

A 
benzos
barbiturates
antihistamines
chloral hydrate 
ethanol
97
Q

What benzdiazepine is often used for sleep maintenance?

A

temazepam

98
Q

What benzodiazepine is often used for short term treatment?

A

triazolam

99
Q

What do benzidiazepines do in regards to sleep?

A

increase total sleep time but may prevent transition from lighter stage 2 sleep into deep restorative stages (stages 3 and 4)

Vicky's Cards - Exam 1 (4 decks)

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