Anxiety/Hypnotic

Question 1

this class of drug suppresses the nervous system

Answer 1

sedative

Question 2

hypnotic vs anxiolytic fxn

Answer 2

Anxiety relief = anxiolytics

Promote sleep = hypnotics

Question 3

A lot of the sedatives are used for anxiety or insomnia management. What determines that difference?

Answer 3

Dosage!

Low = anxiety relief
High = sleep induction

Question 4

2 classes of hypnotics

Answer 4

1. Benzodiazepines
   - ->*drug of choice
2. Benzodiazepine-like drugs

Question 5

which hypnotic class is drug of choice for sleep induction?

Answer 5

Benzodiazepines

Question 6

Why do we like Benzodiazepines more than barbituates?

Answer 6

SAFER!

• ->Lower potential for abuse
• ->Fewer drug interactions

Question 7

prototype for benzodiazepines for hypnotic

Answer 7

triazolam (Halcion)

Question 8

benzodiazepines for anxiety (3)

Answer 8

lorazepam (Ativan) ,
alprazolam (Xanax)
diazepam (Valium),

(this LAD Ben is making me anxious)

Question 9

Random benzo used for procedures prototype

Answer 9

midazolam (Versed)

Question 10

What schedule drugs are benzodiazepines

Answer 10

schedule IV!

Question 11

How do all benzodiazepines fxn?

Answer 11

Potentiate GABA

Question 12

Triazolam- what does it do to your sleep? what happen to your sleep when you stop taking it?

Answer 12

decrease interval to sleep onset, # of intervals of waking = increase total sleep time
-no rebound insomnia!

Question 13

Triazolam- 3 main categories of side effects

Answer 13

1. CNS
2. Cardiovascular
3. Respiratory

Question 14

What will Triazolam do to your CNS? Which of those side effects will improve?

Answer 14

-sedation, confusion, anterograde amnesia, drowsiness, sleep-driving
(sedation and psychomotor slowing improve in 2 weeks)

Question 15

Oral vs IV Triazolam effects on your CV system… how do we give it iv?

Answer 15

Oral – little to no effect on heart and vessels
IV – profound HYPOTENSION and CARDIAC ARREST
= give slowly, port closest to IV

Question 16

Oral vs IV Triazolam effects on respiratory

Answer 16

• Oral – little to no effect
• IV: resp depression (esp if taken w/ other CNS depressant)

-Can worsen airway obstruction in OSA or COPD

Question 17

are we giving Triazolam to a preggo?

Answer 17

no no

Question 18

considerations for stopping Triazolam

Answer 18

• Physical dependence–>wean the drug slowly

- Withdrawal syndrome: If on high doses can be severe (panic, paranoia, delirium, HTN, muscle twitches, convulsions)

Question 19

what is flumazenil (Romazicon)?

how do we give it?

Answer 19

antidote for triazolam

• Admin/ Duration: over 15 seconds. Repeat Q min.
• ->Effects last 1 hour.

Question 20

what does flumazenil (Romazicon) do yo resp. depression?

Answer 20

NOTHING. it only reverses the sedation aspect of overdose on triazolam

Question 21

prototype for hypnotic benzodiazepine like drug?

Answer 21

zolpidem (Ambien)

Question 22

how does zolpidem (Ambien) fxn?

Answer 22

Act as agonists at the benzodiazepine receptor site on the GABA receptor-chloride channel

Question 23

side effects of zolpidem?

Answer 23

• sleep driving

- daytime drowsiness/dizziness (most common)

Question 24

Is zolpidem a scheduled drug?

Answer 24

Class IV, fool

Question 25

What is good about zolpidem?

Answer 25

-no tolerance or physical dependence-->-no rebound insomnia when stopped, no wean off

Question 26

3 classes of drugs to treat anxiety

Answer 26

1.Selective Serotonin Reuptake Inhibitors (SSRI) Discussed later in semester 2.Benzodiazepines Prototype: diazepam (Valium) 3.Non-Benzo; Non-Barbituates Prototype: buspirone (BuSpar) 4.dogs

Question 27

prototype for benzo for anxiety is

Answer 27

diazepam (Valium) I am ANXIOUS every DIA of nursing school

Question 28

prototypes for Non-Benzo; Non-Barbituates for anxiety

Answer 28

buspirone (BuSpar) | Hydroxyzine

Question 29

admin and onset of buspirone (BuSpar)

Answer 29

- Weeks before peak response | - Not for PRN use

Question 30

considerations that make us like buspirone (BuSpar)

Answer 30

- Not a CNS depressant - No abuse potential - No suicide risk - No increased CNS effects with other drugs (ETOH, benzos, etc.)

Question 31

1 thing that makes us sad about buspirone (BuSpar)

Answer 31

no grapefruit

Question 32

Hydroxyzine is what special class of drug that is nonbenzo for anxiety

Answer 32

antihistamine

Question 33

Hydroxyzine is different in admin then buspirone. how?

Answer 33

Hydroxyzine can be taken PRN or QID

Question 34

Prolonged QT interval with which drug long term?

Answer 34

hydroxyzine

Question 35

side effects of hydroxyzine

Answer 35

dry mouth, constipation, confusion, dizziness, headache, fatigue

Question 36

is hydroxyzine a scheduled drug?

Answer 36

no!

Question 37

does hydroxyzine have withdrawal?

Answer 37

no!

Question 38

is hydroxyzine for anxiety only?

Answer 38

No! | anxiety+ insomnia

Question 39

s/s of triazolam withdrawal

Answer 39

(panic, paranoia, delirium, HTN, muscle twitches, convulsions)