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NURS 1446 Psy A > Kach: Anxiolytic & Antidepressants > Flashcards

Kach: Anxiolytic & Antidepressants Flashcards

1
Q

Alcohol enhances this neurotransmitter & depresses this neurotransmitter

A

Enhance GABA

Depress Glutamate

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2
Q

Naltrexone is an opiod antagonists that can be used for alcohol withdrawal

T or F

A

T

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3
Q

Acamprosate differs from Disulfiram how?

A

Disulfiram (Antiabuse) makes one ill if they drink alcohol

Acamprosate helps with alcohol withdrawal symptoms

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4
Q

Cimetidine, oral contraceptives, Disulfiram

Theophylline

Have this affect on Benzodiazepines

A

Cimetidine, oral contraceptives, Disulfiram

Increase affect

Theophylline

Decrease affect

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5
Q

Be prepared to adminster _____ if signs of Benzodiazepine toxicity occurs. (Hypoventilation)

A

Flumazenil

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6
Q
  1. What do Chlordiazepoxide, clonazepam,clorazpate, midazolam and diazepam have in common
  2. Barbiturates have established pediatric doses. What must be monitored very closely?
  3. Antihistamines (diphenhydramine & promethazine) are most popular choice to calm children/ induce sleep. What must be assessed?
A
  1. Established pediatric doses, others must be determined by height & weight.
  2. CNS depression & excitablity
  3. Drying of secretions & breathing
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7
Q

Use of Benzodiazepine & Barbiturates in adults for sleep is only short term.

What 2 precautions must be taken?

A

Liver function & Pregnancy

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8
Q

Sedation Vs Hypnosis

Loss of awareness & reaction to environment

Sleep

A

Sedation
Loss of awareness & reaction to environment

Hypnosis
Sleep

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9
Q

How do Hypnotics work?

A

Act on the Reticular Activating System (RAS)

Block brains response to incoming stimulus

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10
Q

Alcohol

Enhances this neurotransmitter

Inhibits this neurotransmitter

A

Enhances this GABA

Inhibits this Glutamate

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11
Q

Alprazolam (Xanax)

Dosage 0.25 - 0.5mg PO tid up to 10mg

Indications
Onset
Duration

A

Indications: Anxiety / Panic Attack
Onset 30 min
Duration 4 -6 hrs

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12
Q

Alprazolam (Xanax)

Dosage ………

Indications: Panic Attack
Onset 30 min
Duration 4 - 6 hrs

A

Dosage: 0.25 - 0.5mg PO tid up to 10mg

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13
Q

Chlordiazepoxide (Librium)

Dosage: Adult - 5 - 25 mg PO tid - qid
Pediatric: >6 = 5mg PO bid tid

Usage:
Onset:
Duration:

A

Usage: Alcohol withdrawal/ preoperative
Onset: 10 - 15 min
Duration: 2 - 3 days

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14
Q

Chlordiazepoxide (Librium)

Dosage……

Usage: Alcohol withdrawal/ preoperative
Onset: 10 - 15 min
Duration: 2 - 3 days

A

Dosage: 5 - 25 mg tid / qid
Pediatric >6 - 5mg bid / tid

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15
Q

Clonazepam (Klonopin)

Dosage: 0.25 mg bid
Ped: 0.01 - 0.03 mg/kg/d given in 2 - 3 doses Don’t Exceed 0.05 mg/kg/day

Use:
Onset:
Duration:

Special Consideration:

A

Use: Panic Disorder, Restless Legs, Seizures

Onset: Slow

Duration: 1 - 6 weeks

Special Consideration: Suicide, Liver, CBC with long-term

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16
Q

Clonazepam: (Klonopin)

Dosage: 0.25 bid
Peds 0.01 - 0.03 mg/kg/day given 2 - 3 doses

Use:
Onset:
Duration:

Special Consideration:

A

Use: Panic Disorder, Restless Legs, Seizures

Onset: Slow

Duration: 1 - 6 weeks

Special Consideration: Suicide, Liver, CBC with long-term

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17
Q

Clorazpate (Genxene, Tranxene)

Dosage: Anxiety 30 mg divided doses tid. Alcohol withdrawal: Vary

Use

A

Use: Anxiety/ alcohol withdrawal

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18
Q

Clorazpate (Genxene, Tranxene)

Dosage: …….

Use Anxiety/ Alcohol Withdrawal

A

Dosage: Anxiety 30 mg divided doses tid. Alcohol withdrawal: Vary

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19
Q

Diazepam (Valium)

Dose: 2 - 10 mg
Peds: Weight based Dose

Use:
Onset:
Duration:

Special Consideration

A

Use: Anxiety, Alcohol Withdrawal, Muscle Relaxants, Preoperative
Onset: 5 - 60 mins
Duration: 3 hrs

Special Consideration: Taper after longterm therapy

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20
Q

Diazepam (Valium)

Dose….

Use: Anxiety, Alcohol Withdrawal, Muscle Relaxants, Preoperative
Onset: 5 - 60 mins
Duration: 3 hrs

Special Consideration: Taper after longterm therapy

A

Dose: 2 - 10 mg

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21
Q

Estazolam

Dose 1 mg bed time

Use:
Onset:
Duration:

Special Consideration

A

Use: Hypnotic, Insomnia
Onset: 45 - 60 min
Duration: 2 h

Special Consideration: Monitor Liv & Kid / CBC longterm

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22
Q

Estazolam

Dose….

Use: Hypnotic, Insomnia
Onset: 45 - 60 min
Duration: 2 h

Special Consideration: Monitor Liv & Kid / CBC longterm

A

Dose 1 mg PO bedtime

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23
Q

Flurazepam

Dose: 15 - 30 mg Bedtime

Use
Onset
Duration

Special Consideration

A

Use: Hypnotic/ Insomnia
Onset Varies
Duration 30 - 60 mins

Special Consideration Monitor Liv & Kid in longterm CBC

24
Q

Flurazepam

Dose….

Use: Hypnotic/ Insomnia
Onset Varies
Duration 30 - 60 mins

Special Consideration Monitor Liv & Kid in longterm CBC

A

Dose: 15 - 30 mg Bedtime

25
Q

Lorazepam (Ativan)

Dose: 2 - 6mg in divided doses
IM / IV 0.05 mg /kg NO EXCEED 4 mg

Use
Onset
Duration

A

Use Anxiety, Preoperative, Insomnia r/t stress
Onset 1 - 30 Minutos
Duration 12 - 24 hrs

26
Q

Lorazepam (Ativan)

Dose……

Use Anxiety, Preoperative, Insomnia r/t stress
Onset 1 - 30 Minutos
Duration 12 - 24 hrs

A

Dose: 2 - 6mg PO in divided doses or
0.05 mg/kg IM / IV Max 4 mg

27
Q

Midazolam

Dose: Sedation 5 mg IM
Conscious Sedation (Short Procedures) 1 - 2.5 mg IV maintenance Dose = 25% of initial Dose
Sedation in critical care: 10 - 50 mcg/kg IV loading Dose, repeat every 10 - 15 min until desired effects seen.
Maintenance 20 - 100 mcg/kg/h

Use:
Onset:
Duration:

Special Consideration

A

Use: Sedation, Anxiety, Conscious Sedation, Continous Sedation for intubation or ventilated patients
Onset: 3 - 15 min
Duration: 2 - 6 hrs

Special Consideration Don’t adminster in Artery.
Keep resuscitation equipment near.

28
Q

Midazolam

Dose

Sedation / Maintenance Dose

Sedation in critical care

Use: Sedation, Anxiety, Conscious Sedation, Continous Sedation

Onset 3 - 15 min

Duration: 12 - 24 hrs

Special Consideration: No Arterial Administration. Keep resuscitation equipment nearby

A

Dose: Sedation 5 mg IM
Conscious Sedation (Short Procedures) 1 - 2.5 mg IV maintenance Dose = 25% of initial Dose
Sedation in critical care: 10 - 50 mcg/kg IV loading Dose, repeat every 10 - 15 min until desired effects seen.
Maintenance 20 - 100 mcg/kg/h

29
Q

Oxazepam

Dose: 10 - 15 mg PO tid qid

Use
Onset
Duration

Special Consideration

A

Use Anxiety, Alcohol Withdrawal
Onset Slow
Duration 2 - 4 hrs

Special Consideration: Preferred in Older Adults

30
Q

Quazepam (Doral)

Dose: 15 mg Bedtime

Use
Onset
Duration

Special Consideration

A

Use Insomnia
Onset Varies
Duration 4 - 5 hrs

Special Consideration Monitor Liv and Kid CBC

31
Q

Quazepam (Doral)

Dose: …

Use Insomnia
Onset Varies
Duration 4 - 5 hrs

Special Consideration Monitor Liv and Kid CBC

A

Dose 15 mg

32
Q

Temazepam (Restoril)

Dose: 15 - 30 mg Bedtime 7 - 10 d

Use
Onset
Duration

Special Consideration

A

Use Insomnia
Onset Varies
Duration 4 - 6 hr

Special Consideration Taper after longterm

33
Q

Tenazepam ( Restoril)

Dose:

Use Insomnia
Onset Varies
Duration 4 - 6 hr

Special Consideration Taper after longterm

A

Dose: 15 - 30 mg Bedtime 7 - 10 d

34
Q

Triazolam (Halcion)

Dose 0.125 - 0.5 mg Bedtime 7 - 10 days

Use
Onset
Duration

A

Use Insomnia
Onset Varies
Duration 2 - 4 hrs

35
Q

How long for peak levels of Benzodiazepines

A

30 min - 2 hrs

36
Q

Birth defects from Benzodiazepine

A

Cleft lip, inguinal hernia, Cardiac defects (pyloric stenosis), microcephaly

37
Q

Barbiturates reach peak level in …

A

20 - 60 min

38
Q

Barbiturates

Butabarbital

15 - 30 mg tid / qid - 50 - 100mg Bedtime

Peds 2 - 6 mg/kg 100 max

Use
Onset
Duration

Special Consideration

A

Use Short-term sedative Hypnotic (Sleep)
Onset 45 - 60 min
Duration 6 - 8 hrs

Special Consideration Taper gradually, May produce Aggressiveness on children

39
Q

Barbiturates

Butabarbital

Dose…

Use Short-term sedative Hypnotic (Sleep)
Onset 45 - 60 min
Duration 6 - 8 hrs

Special Consideration Taper gradually, May produce Aggressiveness on children

A

Dose 15 - 30 tid / qid - 50 - 100 mg Bedtime

Peds: 2 - 6 mg/kg Max 100mg

40
Q

Barbiturates

Pentobarbital

Dose 20mg tid / qid 100mg Bedtime
120 - 200 PR, 150 - 200mg IM

Use
Onset
Duration
Special Consideration

A

Use Sedative Hypnotic Preoperative
Onset 10 - 15 min
Duration 2 - 4 hrs
Special Consideration Taper gradually/ Monitor injection sites

41
Q

Barbiturates

Pentobarbital

Dose…..

Use Sedative Hypnotic Preoperative
Onset 10 - 15 min
Duration 2 - 4 hrs
Special Consideration Taper gradually/ Monitor injection sites

A

Dose 20 mg tid qid, 100mg Bedtime, 120 - 200 PR, 150 - 200 IM

42
Q

Barbiturates

Phenobarbital

Dose 30 - 120 mg PO IV IM

Use
Onset
Duration

A

Use Sedative Hypnotic, Control Seizures, Preoperative
Onset 10 - 60 min
Duration 4 - 16 hrs

43
Q

Barbiturates

Phenobarbital

Dose…..

Use Sedative Hypnotic, Control Seizures, Preoperative
Onset 10 - 60 min
Duration 4 - 16 hrs

A

Dose 30 - 120 mg PO, IM, IV

44
Q

Barbiturates

Secobarbital

Dose: 100 - 300mg

Use
Onset
Duration

A

Use: Preoperative, Convulsiones of tetanus
Onset Rapid
Duration 1 - 4 hrs

45
Q

Barbiturates

Secobarbital

Dose…

Use: Preoperative, Convulsiones of tetanus
Onset Rapid
Duration 1 - 4 hrs

A

Dose 100 - 300 mg

46
Q

Most common adverse affects include:

Drowsiness
Somnolencia
Lethargy
Ataxia
Vertigo
Hangover
Thinking abnormalities
Paradoxical excitement
Anxiety
Hallucinations

N/V
C or D

Bradycardia
Hypotension
Syncope
Hypoventilation

Steven Johnsons Syndrome

A

Barbiturates

47
Q

Buspirone

Dose…..

Use: Anxiety

SE dry mouth headache

A

Dose Start 15 titrate up to 60mg/ d

48
Q

Diphenhydramine

Dose….

Use: Sleep aid. Motion Sickness, short term insomnia

A

Dose: 25 - 50 mg q 4 - 6

IV / IM 10 -50

400 mg / d Max

49
Q

Eszopiclone

Dose…

Use: Insomnia

A

1 mg before bed

3 mg max

50
Q

Meprobamate:

Dose….

Use: Short term anxiety

A

1,200 - 1,600 in 3-4 doses

51
Q

Promethazine (Antihystimine)

Dose

Use: Post op pain relief & Sedation

A

25 - 50 mg

Caution thickening secretions, lower respitory

52
Q

Ramelteon (Melatonin Receptor Agonist)

Dose…

Use: Insomnia characterized by dif falling asleep

A

8 mg bed time

53
Q

Suvorexant (Orexin receptor Antagonist)

Dose….

Use: Insomnia

A

10 mg 20 mg Max bed time

54
Q

Tasomelteon

Dose….

Use: Melatonin Receptor Agonist that helps with sleep in the blind & non-24 hr sleep-wake disorder

A

20 mg Bedtime

55
Q

Zaleplon

Dose…

Use: Short-term insomnia help. Bind to GABA

A

10mg bedtime

56
Q

Zolpidem

Dose…..

Use: Short-term insomnia treatment.

A

5 mg Bedtime/ 10 mg Bedtime

Available in Extended Releaee & Oral Spray

57
Q

Zolpidem

Dose…..

Use: Short-term insomnia treatment.

A

5 mg Bedtime/ 10 mg Bedtime

Available in Extended Releaee & Oral Spray

NURS 1446 Psy A (19 decks)

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