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Pharmacology > Pharm2 6 Neuro pt2 > Flashcards

Pharm2 6 Neuro pt2 Flashcards

1
Q

Anxiety is most frequently divided into two common but distinctly different categories:

A

Generalized anxiety disorder
Panic disorder
(There are many others including phobias, OCD, PTSD, performance anxiety, test anxiety, and others)

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2
Q

Difficult to control, excessive anxiety
Last 6 or more months
Interferes with normal day to day functions or causes considerable distress

A

General anxiety disorder

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3
Q

Intermittent, intense, immediate episodes of fear, terror resulting in changing of behavior to avoid attacks
May be associated with hyperventilation, mimic heart attack

A

Panic Disorder

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4
Q

What CLASS is the Prototypical Anxiolytic/CNS Depressant? What route of admins does it exist in? (4)

A

Benzodiazepines

Available PO, PR, IV, IM

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5
Q

“Benzos” are used primarily for many anxieties

Also used to do what? (2)

A

break active, grand mal seizures, emergent sedation

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6
Q

Regarding Benzos, outpatient requires ____.
Quantities monitored carefully by State
Cannot be “phoned in”

A

“triplicates”

they are habituating, addictive

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7
Q

What is the prototypical benzodiazepine?

A

Alprozolam (Xanax®)

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8
Q

Alprozolam (Xanax®)
Indications
Mechanism of action

A

Indications: Short-term treatment of anxiety, panic attacks
Mechanism of action: Bind to gama-amino butyric acid (GABA) receptor-chloride channels molecules increasing the effect of GABA, a natural inhibitor neurotransmitter

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9
Q

Alprozolam (Xanax®)
Adverse Effects
Contraindications

A

Adverse Effects: CNS depression, drowsiness, dizziness, memory impairment, ataxia, hypotension, withdrawal seizures, dependence, esp. in elderly, debilitated, concomitant ETOH use
Contraindications: Allergy, glaucoma, drug/ETOH abuse, suicidal tendencies

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10
Q

Short term behavioral insomnia is frequently associated with ___. What else? (2)

A

stress
Exogenous consumption, esp. caffeine, ETOH, tobacco
Change in routine, travel, time zones

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11
Q

Long-term insomnia may be due to (3)

A

seconday to pain, psych problems, medication side fx

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12
Q 
Insomnia
Epidemiology:
Which gender is it more common?
Occurs in # out of # adults annually
As you age, you typically need \_\_ sleep
A

F > M
1 in 3 adults annually
less sleep

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13
Q

What are largest category of drugs sold?

A

OTC sleep aides

Tylenol PM, Unisom, Nytol, etc.

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14
Q

Prototypical CNS Hypnotic for sleep:

A

Zolpidem (Ambien®)

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15
Q

Zolpidem (Ambien®)
Indications
Mechanism of action

A

Indications: Short-term treatment of insomnia, to treat (not induce) daytime sedation by regulating sleep cycles
Mechanism of action: hypnotic with intermediate-term benzodiazepine-like action suppressing brain impulses through limbic and reticular activating system

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16
Q

Zolpidem (Ambien®)
Adverse Effects
Contraindications

A

Adverse Effects: Dizziness, daytime drowsiness, amnesia, “drugged feeling”
Contraindications: Allergy, compromised respiratory function, concomitant ETOH use, depression, debilitated/elderly, inability to get > 7 hours of uninterrupted sleep

17
Q

Prototypical CNS Hypnotic for sleep:

A

Zaleplon (Sonata®)

18
Q

Zaleplon (Sonata®)
Indications
Mechanism of action

A

Indications: Short-term treatment of insomnia, to treat (not induce) daytime sedation by regulating sleep cycles
Mechanism of action: hypnotic with short-term benzodiazepine-like action suppressing brain impulses through limbic and reticular activating system

19
Q

Zaleplon (Sonata®)
Adverse Effects
Contraindications

A

Adverse Effects: Dizziness, daytime drowsiness, amnesia, parathesias, “drugged feeling”
Contraindications: Allergy, severe hepatic impairment, compromised respiratory function, concomitant ETOH use, depression, debilitated/elderly

20
Q

With Doxazocin, what must you warn them when they start taking it?

A

Hypotension ESPECIALLY WITH THE 1ST few doses.

21
Q

Most Benzos are schedule ___

A

III

22
Q

By far the most prescribed of Benzos:

A

Xanax

23
Q

If dosed high enough, xanax (benzos) can have what effect?

A

It takes all the highs and lows away, if dosed high enough.

24
Q

What occurs in Benzos (Xanax) to differing degrees?

A

*memory impairment for all the Benzo’s, to different degrees. You need to document that you told them not to drive for this

25
Q

Benzo’s and seizures info:

Why be careful when taking someone off this who was taking it for seizures

A

Benzo’s raise seizure threshold – prevent them from happening.
So if they have a propensity and you LOWER the Benzo, then they’re at higher risk of the seizure.

26
Q

Besides Xanax, name 3 other benzo’s and their routes of admin:
Which one is a unique route of admin? (and what is it?)

A

Valium (PO, IV), Adovan (IM, IV), Midazolam (IM, IV)

Valium is PO (and injectable like the others)

27
Q

Name 2 much longer lasting Benzo’s than Xanax

A

Valium & Adovan

28
Q

Which Benzo is shortest-acting?

A

Midazolam (Versed)

Much shorter acting

29
Q

Flunitrazepam aka Roofies are technically in what class of drugs?

A

Benzo’s

30
Q

Besides meds, if they have insomnia, what else can you do to help ‘em?

A

tell them they need a food diary. Identify things containing caffeine

31
Q

Why can alcohol cause insomnia?

A

B/c it wears off, you sober, and you can’t fall back asleep

32
Q

What soda contains the most caffeine?

A

Mountain Dew

33
Q

Time zone counseling (w/o meds)

A

ever day adjust your clock about an hour so you adjust to the time zone. If it’s only a day, stay on your local time.

34
Q

Drug tx for ppl who moved half way around the world and/or needs to stay up to work their shift (police officers, fire fighters, & PA’s!)

A

Modafonil, Armodafonil

35
Q

with insomnia, Advise patient to do what b4 you resort to drugs?

A
  • Sleep hygiene – go to bed ‘cleanly’ the same time every night. No caffeine, no exercise, food, and with a soft light read a book – not a magazine/catalog for 20 min, then turn the light off. If 20 min pass and you can’t fall asleep, then you give them the sleep aide. Should not have a tv/radio in the bedroom
36
Q

What is the main ingredient (and therefore an alternative choice) in OTC sleep aides like Tylenol PM, Unisom, Nytol?

A

Diphenhydramine

37
Q

___ hits the Benzo receptor even though it isn’t a Benzo.

A

Ambien

38
Q

What’s a unique adverse effect for Ambien & Sonata? (sleep meds)

A

Drugged-feeling

Pharmacology (54 decks)

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