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Pharm 4
Chap 19
| Question | Answer |
|---|---|
| Benzodiazepines indications | anxiety, insomnia, muscle spasm, seizure, spasticity, alcohol withdrawal - short term use |
| Benzodiazepines s/e | motor incoordination, dizziness, excessive drowsiness; impair cognitive processing and affect concentration, judgment and planning; interfere driving, and psychomotor skills |
| Long-term use of benzo effects | physical dependence |
| abrubtly discontinued benzo | withdrawal syndrome: rebound anxiety, insomnia, headach, irritability, muscle twitches |
| abrupt withdrawal from alprazolam | seizures |
| benzo and barbituates | reinforcing effects of benzo is less than the reinforcing effects of barbiturates, but greater than reinforcing effects of sedating antihistamins; massive overdose less likely to cause fatal than Barbi |
| Benzodiazepine and pregnancy | category D, can't use long term for pregnancy |
| Diazepam indications | also for acute seizures, severe muscle spasm, spasticity |
| Lorazepam indications | anxiety and seizures |
| Temazepam, Flurazepam, triazolam indications | insomnia |
| Lorezepam and temazepam | preferred for elderly |
| Triazolam s/e | amnesia, confusion, delirium esp in elderly |
| Alprazolam, indications | anxiey, panic disorder |
| clonazepam indications | anxiey, panic disorder, Seizures |
| midazolam | IV for anesthetic for pt going to surgery |
| Barbiturates indications | anxiety disorders, insomnia, seizures, anesthesia |
| Benzo vs Barbiturates uses | Barbiturates do not produce significant muscle relaxation and are not used in treating muscle spasm or spasticity disorders, massive use of Barbi can be more fatal |
| phenobarbital indications | seizures |
| Antihistamines (dyphenhydramine) | treat mild insomnia, anxiety, sleep preparations, sedative before surgery |
| Antihistamines characteristics | sedation, blood-brain barrier, block acetylcholine release induce drowsiness and sleep |
| Zolpidem, zaleplon, eszopiclone | newer agents for insomnia |
| Different between this new group and old benzo (short vs long acting) | - less adverse effects - weaker daytime sedation and hangover effect due to shorter elimination halflife. Old benzo are less selective in choosing receptor and bind to a more widespread distribution of receptors |
| Melatonin indications | treatment of jet lag, insomnia in shift-changed workers and elderly, delayed sleep-phase syndrome and non-24 hour sleep-wake disorder |
| Ramelteon indications | sleep-onset insomnia |
| Non-benzo anxyolitics | propanolol and buspirone |
| Buspirone | treatment of chronic anxiety by anxiolytic effect |
| Buspirone special | anxiolytic effects without causing marked sedation, amnesia, tolerance, dependence |
| Buspirone s/e | headache, dizziness, nervousness |
| Propanolol | prevent tachycardia and other signs of stage fright/ acute situational or perfomance anxiety. - take 1 hour before anxiety-provoking |
Created by:
prinluu
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