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Physcotherapeutic Dr
GWCC Block 1 nursing
| Question | Answer |
|---|---|
| Three classes of antianxiety drugs | a) benzodiazepines b) antihistamines c) misc. drugs |
| What benzodiazepines are used for anxiety? AVVXKL | lorazepam (Avitan) diazepam (Valium) midazolam (Versed) alprazolam (Xanax) clonazepam (Klonopin) chloridiazepoxide (Librium) |
| What antihistamines are used for anxiety? | hydroxizine hydrochloride (Atarax, Vistaril) |
| What reverses benzodiazepines after surgery or OD? | Flumazenil |
| Misc. drug taken for anxiety, and the advantages over other drugs used for anxiety. | buspirone (BuSpar) non-sedating, non habit-forming. |
| What drugs (list classes) are used for sedative hypnotic purposes? | A) Barbiturates B) Non-Barbituates 1) Benzodiazepines 2) non-Benzodiazepines |
| How do sedative-hypnotic drugs work? | They work by increasing the level of GABA in the brain (CNS), which is responsible for sleep. |
| What drug interactions and adverse effects occur with barbiturates? | They are addictive. Deprive people of REM sleep. Overdose can cause coma or death, depressed respiration. Narrow therapeutic index Interacts with ETOH, anti-histamines, benzodiazepines, opiods, tranquilizers. Enzyme induction results in increased dru |
| The main difference among the different barbiturates is ____________. | their half-life |
| Long-acting barbiturates | phenobarbital (Nembutal) mephobarbital (Mebaral) |
| Intermediate acting barbiturates | amobarbital sodium (Amytal Sodium) butabarbital sodium (Butisol) |
| Short- acting barbiturates | secobarbital sodium (Seconal Sodium Pulvules) pentobarbital sodium |
| Barbiturates are used to treat- | anxiety, insomnia, seizure disorders |
| What are the advantages of using benzodiazepines vs. barbiturates for sleep/sedation? | More commonly prescribed than barbiturates. Safer, less adverse effects. Does not suppress REM sleep. Do not induce enzyme reactions and metabolism problems. |
| What are some risks of benzodiazepines, including interactions? | Causes hangovers, fall risk. Active metabolites can increase during long-term use. Interactions: grapefruit, other CNS depressants, ETOH, etc. May be issues of dependence, toxicity, and abuse.Oral contraceptives, cimetidine (Tagamet), disulfiram (Antab |
| What reverses the effects of benzodiazepines? | Flumazenil reverses benzodiazepines after surgery or OD. |
| What are some examples of benzodiazepines used for sedation/sleep? DDHPR | flurazepam (Dalmane) quazepam (Doral) triazolam (Halcion) estazolam (Prosom) temazepam (Restoril) |
| What non-benzodiazepines are used for the treatment of insomnia? ASRNLP | zolpidem (Ambien, Ambien CR) pyrazolopyrimidine (Sonata) ramelteon (Rozerem) chloral hydrate (Noctec) eszopiclone (Lunesta) dexmedetomidine hydrochloride (Precedex) |
| What classes of drugs are used for antianxiety? | A) Benzodiazepines B) Antihistimines C) Misc. |
| Describe anxiety disorders- symptoms and brain chemistry | Anxiety disorders are associated with certain chemical imbalances in the brain involving neurotransmitters such as serotonin, norepinephrine, and gamma aminobutyric acid or GABA. |
| What are some names of benzodiazepines that treat anxiety? VVAXKL | diazepam (Valium) midazolam (Versed) lorazepam (Avitan) alprazolam (Xanax) clonazepam (Klonopin) chloridiazepoxide (Librium) |
| What antihistamines are used to treat anxiety? | hydroxizine hydrochloride (Atarax, Vistaril) |
| What misc. drug is used to treat anxiety? What are the advantages and side effects? | buspirone (BuSpar) non-sedating, non habit-forming. risk for serotonin syndrome when taken with antidepressants |
| What chemicals play a role in the pathology of Manic Depressive/ Bipolar Disorder? | The chatacholines (dopamine, norepinephrine) and serotonin play an important role in the pathology of MDC. |
| What drugs are used to treat BPD? | Lithium salts- used to treat a manic episode valproic acid- used as a maintenance drug and better for the older population (safer) |
| What are the safe and unsafe blood serum levels of lithium? | Lithium can be extremely toxic! - must maintain a serum level of 0,6 -1.2 - over 1.5 starts to have toxic effects - over 3.0 can lead to death! |
| Why must Na+ levels be monitored when taking lithium? | The body cannot distinguish between Lithium and Na+, so if the pt. gets low on Na+, Lithium is retained instead, and this can lead to toxic levels, and hyponatremia. |
| What other labs must be monitored besides Na+ when taking lithium? | creatinine thyroid |
| People with the following conditions should avoid taking lithium- | Avoid Lithium in pregnancy (leads to birth defects), and in pt with renal, cardiovascular, and hypertensive disorders, diabetes, or electrolyte imbalances. |
| How often is lithium given per day? | Lithium is usually given 2x a day to maintain a consistent blood level. |
| What drug is better than lithium for older people and why? | Valproic acid is a better choice for older people, who metabolize drugs more slowly and because lithium patients require frequent monitoring. It's also used as a maintenance drug for mania, whereas Lithium is often given for episodes. |
| How do antipsychotic drugs work? | Increase dopamine concentrations in the CNS, in areas associated with cognitive, emotional, and motor function. All beneficial and adverse effects come from the increased levels of dopamine, and blocked dopamine receptors. |
| What classes of drugs are used to treat psychotic disorders? | A) Phenothiazines B) AAP's (atypical antipsychotics) |
| Signs of lithium toxicity | vomiting, diarrhea, lack of coordination (ataxia), slurred speech, dizziness and confusion, muscle twitching, hypotension, irregular pulse, seizures, cardiac arrest |
| How do anti-depressants work? | Increase the monoamine neurotransmitters: serotonin, dopamine, norepinephrine. |
| What classes of anti-depressants are available? | A) NGA's (Newer Generation Antidepressants) 1) SSRI's 2) 2nd Generation TCA's 3) 3rd Generation TCA's B) TCA's (Trycyclic Antidepressants) C) MAOI's (Monoamine Oxidase Inhibitors) |
| What are some potential side effects of SSRIs? | sexual problems including low sex drive or inability to have an orgasm, dizziness, headaches, nausea right after a dose, insomnia and jitters. SSRIs and what they do. |
| What are the names of SSRI drugs? CLLPP | citalopram (Celexa) escitalopram oxalate (Lexapro) fluvoxamine maleate (Luvox) paroxetine hydrochloride (Paxil) fluoxetine hydrochloride (Prozac) Zoloft sertraline hydrochloride |
| How do 2nd and 3rd generation TCAs work? What are their side effects? | Increase the levels of the neurotransmitters serotonin and norepinephrine. Side effects: drowsiness, blurred vision, lightheadedness, strange dreams, constipation, fever/chills, headache, increased or decreased appetite, tremor, dry mouth, nausea. |
| What are the names of 2nd and 3rd generation antidepressants? CDEWR | duloxetine hydrochloride (Cymbalta) venlafaxine hydrochloride(Effexor) mirtazapine (Remeren) bupropion hydrochloride (Wellbutrin) trazodone hydrochloride (Desyrel) |
| What leads to the common side effects of TCA's? | Non-specific antagonism of muliple receptor types contributes to their adverse effects. They are not as selective as the NGA's. TCA OD's are notoriously lethal! |
| What are potential side effects of TCA's? | Dry mouth, blurred vision, increased fatigue and sleepiness, weight gain, muscle twitching (tremors), constipation, bladder problems such as urine retention, dizziness, daytime drowsiness, orthostatic hypotension, increased heart rate, sexual problems. |
| What are some examples of TCA drugs (all end with __) | (Anafranil) clomipramine hydrochloride Elavil (discontinued, US) amitriptyline hydrochloride (Norpramin) desipramine hydrochloride (Pamelor) nortriptyline hydrochloride (Sinequan) doxepin hydrochloride (Surmontil) trimipramine maleate |
| What risks are there with taking MAOI's? | The biggest adverse effect is a hypertensive crisis caused by the consumption of tryamine, which is found in many foods and beverages and common medicines. barbiturates, TCA's, antihistamines, CNS depressants, antihypertensives, OTC cold meds. |
| What are the symptoms of an MAOI drug/food interaction? | headache, heart racing, chest pain, neck stiffness, nausea and vomiting. Symptoms appear in 12 hours. |
| What are the names of MAOI drugs? | Nardil, Parnate, Marplan |
| Which type of antidepressant has is very lethal if there is an overdose? | TCA's are very lethal, with 70-80% of patients dying before they reach the hospital. Death results from seizures or heart dysrhythmias. |
| What was the first drug to successfully treat schizophrenia? | Thorazine |
| What are some AAP's? (atypical antipsychotics) | Clozapine (Clozaril) Risperidone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Ziprasidone (Geodon) Aripiprazole (Abilify) |
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AmericanChai
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