Chap 19
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Benzodiazepines indications | anxiety, insomnia, muscle spasm, seizure, spasticity, alcohol withdrawal
- short term use
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| Benzodiazepines s/e | motor incoordination, dizziness, excessive drowsiness; impair cognitive processing and affect concentration, judgment and planning; interfere driving, and psychomotor skills
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| Long-term use of benzo effects | physical dependence
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| abrubtly discontinued benzo | withdrawal syndrome: rebound anxiety, insomnia, headach, irritability, muscle twitches
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| abrupt withdrawal from alprazolam | seizures
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| 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
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| Benzodiazepine and pregnancy | category D, can't use long term for pregnancy
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| Diazepam indications | also for acute seizures, severe muscle spasm, spasticity
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| Lorazepam indications | anxiety and seizures
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| Temazepam, Flurazepam, triazolam indications | insomnia
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| Lorezepam and temazepam | preferred for elderly
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| Triazolam s/e | amnesia, confusion, delirium esp in elderly
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| Alprazolam, indications | anxiey, panic disorder
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| clonazepam indications | anxiey, panic disorder, Seizures
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| midazolam | IV for anesthetic for pt going to surgery
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| Barbiturates indications | anxiety disorders, insomnia, seizures, anesthesia
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| 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
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| phenobarbital indications | seizures
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| Antihistamines (dyphenhydramine) | treat mild insomnia, anxiety, sleep preparations, sedative before surgery
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| Antihistamines characteristics | sedation, blood-brain barrier, block acetylcholine release induce drowsiness and sleep
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| Zolpidem, zaleplon, eszopiclone | newer agents for insomnia
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| 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
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| Melatonin indications | treatment of jet lag, insomnia in shift-changed workers and elderly, delayed sleep-phase syndrome and non-24 hour sleep-wake disorder
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| Ramelteon indications | sleep-onset insomnia
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| Non-benzo anxyolitics | propanolol and buspirone
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| Buspirone | treatment of chronic anxiety by anxiolytic effect
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| Buspirone special | anxiolytic effects without causing marked sedation, amnesia, tolerance, dependence
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| Buspirone s/e | headache, dizziness, nervousness
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| Propanolol | prevent tachycardia and other signs of stage fright/ acute situational or perfomance anxiety. - take 1 hour before anxiety-provoking
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