Sedative-Hypnotics, anti-anxiety, antidepressants

Question 1

What are the two categories of sedative-hypnotics?

Answer 1

benzos and non-benzos

Question 2

How do benzo’s work?

Answer 2

increase inhibition of CNS synapses that use neurotransmitter GABA (effect of GABA is increased that increases relaxation)

Question 3

What are the side effects of benzos?

Answer 3

hang over effect that can affect motor performance and anterograde amnesia

Question 4

What do benzos tend to end in (name wise)?

Answer 4

end in -am

Question 5

T/F, barbituates are commonly used for sleep-hypnosis

Answer 5

false, very small therapeutic index and very addictive

Question 6

How do barbiturates work and what do they indicate and what are some of their side effects?

Answer 6

Binds to GABA receptors and is used to promote sleep, hypnosis and depresses CNS in higher doses, can be very addictive and have a hang over effect

Question 7

What do barbiturates tend to end with name wise?

Answer 7

-al

Question 8

T/F, for sedative-hypnotics, the drug should be stopped abruptly if it has been used for an extended period

Answer 8

false, it should be tapered off as tolerance has been built up to it

Question 9

T/F, benzos can be used to help treat anxiety

Answer 9

true, inhibits the SC which then helps with skeletal muscle relaxation

Question 10

What can happen if you remove the benzo medication that was used to treat anxiety?

Answer 10

rebound anxiety- anxiety returns to levels at pre-treatment

Question 11

What anxiety medication is a good choice for someone who needs long term treatment and helps increase the effects of serotonin?

Answer 11

buspirone

Question 12

T/F, you can’t use antidepressants to treat anxiety

Answer 12

false! they have a low risk of addiction and are an effective way to treat anxiety

Question 13

T/F, beta blockers are used to treat anxiety

Answer 13

true, decrease anxiety by blocking the sympathetic nervous system

Question 14

T/F benzos and other drugs that treat sleep disorders and anxiety are associated with increased fall risk and hip fractures in older adults

Answer 14

True, can put them at risk for fractures and falls

Question 15

Which type of disorders describe a group of mental disorders that include depression, and bipolar syndrome (manic-depression)?

Answer 15

affective disorders

Question 16

What are the categories of medications that help treat depression?

Answer 16

SSRI, SNRI, Tricyclics, Monoamine oxidase inhibitors (MOA)

Question 17

Which anti-depressant works by blocking the reuptake of serotonin into the presynaptic terminal which allows for it to remain in the cleft and exert its effect longer?

Answer 17

SSRI (selective serotonin reuptake inhibitors)

Question 18

T/F, SSRI are not selective and have more side effects

Answer 18

false, are very selective and have fewer side effects which improves adherence and compliance

Question 19

Which are the newer class of antidepressants that helps decrease serotonin and norepinephrine uptake?

Answer 19

SNRI (serotonin-norepinephrine reuptake inhibitors)

Question 20

Which antidepressants block the reuptake AMINE nt and is NOT SELECTIVE and affects all three synapses: serotonin, norepinephrine and dopamine

Answer 20

tricyclics

Question 21

You have a pt taking MAO’s, what do you need to warn them nutrionally?

Answer 21

to avoid foods that have tyramine

Question 22

How do MAOs work to treat depression?

Answer 22

inhibit enzyme that removes released NTs which allows it to have more of an effect

Question 23

Which antidepressant helps stimulate appetite?

Answer 23

mirtazapine/remeron

Question 24

What are some anticholinergic effects of SSRIs and SNRIs?

Answer 24

dry mouth, constipation, urinary retention, confusion-> can’t see, can’t pee, can’t poop

Question 25

What is the most serious side effect of SSRIs and SNRIs?

Answer 25

serotonin syndrome: serotonin builds up and can lead to seizures, coma or death and drug needs to be STOPPED RIGHT AWAY

Question 26

What are some of the side effects of tricyclics?

Answer 26

sluggishness, anticholinergic (cant see, poop, pee), lethal overdose that can cause fatal arrhythmias, orthostatic hypotension-> fall risks

Question 27

T/F, many chronic pain syndromes can be treated more effectively if an antidepressant is also used

Answer 27

true, even if the pt does not have depression, it can help with chronic pain

Question 28

What is the primary drug used to treat bipolar disorder

Answer 28

lithium

Question 29

What are some main side effects to look out for someone taking lithium?

Answer 29

sedation, lethargy, muscle weakness

Question 30

What are some MAO side effects to look out for as a PT?

Answer 30

monitor BP as drug can increase BP and want to ensure pt does not go into hypertensive crisis

Question 31

T/F, depression increases during the initial tx period (2-4 weeks)

Answer 31

true, which can make adherence to taking meds hard when they do not see the benefits right away