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Sedative/hypnotic
Mod 4 Pharm
| Question | Answer |
|---|---|
| What type of medication produces a calming effect and reduces anxiety? | anxiolytic or sedative |
| What type of medication produces drowsiness and aides sleep? | hypnotic |
| What is most widely used sedative-hypnotic? | benzodiazepines |
| What are the major uses of benzodiazepines? | relieve anxiety insomnia sedation/amnesia before procedure control epilepsy and seizure states |
| Name 5 benzodiazepines: | alprazolam (Xanax) clonazepam (Klonipin) diazepam (Valium) lorazepam (Ativan) temazepam (Restoril) |
| What benzodiazepine is a pregnancy risk category C? | clonazepam |
| What schedule are benzodiazepines? | Schedule IV |
| What benzo. is a pregnancy risk category X? | Temazepam |
| What benzodiazepines are pregnancy risk category D? | Alprazolam Lorazepam |
| What is initial dose of alprazolam? | 0.25mg-0.5mg TID |
| What is the maximum daily dose of alprazolam? | 4mg |
| Can a patient who is breastfeeding take alprazolam? | NO, avoid use in breast-feeding women |
| What teaching should be included with prescribing of alprazolam? | dizziness is possible with sudden posture changes |
| SALAD of alprazolam (Xanax): | Zantac (ranitidine); Zyrtec (certirizine) |
| What is the brand name of clonazepam: | Klonopin |
| What is the major use of clonazepam | seizures |
| Should patients suddenly stop taking clonazepam | NO-abrupt withdrawal may cause seizures |
| What is the initial dose of clonazepam | 1.5mg/day in divided doses |
| SALAD for clonazepam | clonidine, lorazepam, diazepam |
| What is the brand name for diazepam | Valium |
| What is the dose range for diazepam | 2010mg bid to qid |
| What is diazepam used for: | anxiety, acute alcohol wd, muscle spasm, tetanus, status epilepticus |
| How is diazepam available: | tablets, capsules, oral solution, injection, rectal |
| Should diazepam be stored in plastic syringe? | No, diazepam interacts with plastic |
| How should diazepam & lorazepam be stopped? | discontinue drug slowly over 8-12 wks after long term therapy |
| SALAD for diazepam: | ditropan (oxybutynin) |
| What is the brand name of lorazepam? | Ativan |
| What is the usual dose of lorazepam? | 2-3mg in 2-3 divided doses |
| What is the use of lorazepam? | anxiety, insomnia, preop |
| How is lorazepam available? | tablet, solution, injection |
| How does large amounts of caffeine affect lorazepam? | caffeine interfers with effectiveness of lorazepam |
| SALAD of Ativan: | Atarax (hydroxyzine) |
| What is name brand of temazepam? | Restoril |
| What is dose of temazepam? | 7.5-30mg 30 min before bed |
| How long can temazepam be used | up to 4 weeks (then not as effective) |
| How should temazepam be stopped? | taper withdrawal schedule |
| What is brand name of buspirone? | Buspar |
| SALD of buspirone? | bupropion |
| What is pregnancy risk class of buspirone? | B |
| If pt previously taking benzodiazepines is buspirone effective? | NO, buspirone may not be effective if previously on benzo. |
| How long before buspirone effective? | 2 weeks or more |
| What is initial dose of buspirone | 5mg TID |
| what is usual maintenance dose of buspirone | 20-30mg daily in divided doses |
| What is maximum dose of buspirone | 60mg |
| What is an absolute contraindication to buspirone? | MAOI cause serotonin syndrome |
| How much time should separate dosages of serotongeric drugs and MAOIs? | at least 14 days (prefer 18-20) |
| What are the brand name of hydroxyzine? | Atarax, Vistaril |
| What is usual dose of hydroxyzine? | 50-100mg QID |
| What are uses of hydroxyzine? | anti-anxiety, sedative, anti-pruritic, anti-emetic, amnti-spasmodic |
| What is the pregnancy risk category of hydroxyzine? | C (NOT to be taken in early pregnancy) |
| Can pt drink alcohol while taking hydroxyzine? | No |
| How is hydroxyzine available? | |
| Should pt continue hydroxyzine before skin allergy test? | No, hydroxyzine may cause false-negative skin allergy test |
| What is the generic name for Ambien? | zolpidem |
| What is the usual dose of zolpidem? | 10 mg before bed |
| What is the pregnancy risk category of zolpidem? | B |
| How long can pt take zolpidem before developing tolerance? | in a few weeks |
| What is the limit to drug therapy of zolpidem? | 7-10 days |
| What behavior should be monitored in pt who are depressed, suicidal, or known to abuse drugs? | hoarding, self-overdosing |
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