Benzo and Mood Stabilizers Flashcards Preview

Psych > Benzo and Mood Stabilizers > Flashcards

Flashcards in Benzo and Mood Stabilizers Deck (61)
Loading flashcards...
1

What are the properties of benzos?

Anxiolytic
Hypnotic

2

What do anxiolytic agents do?

Reduces anxiety and produces a calming effect with little effect on motor and mental functions
Decreases activity, moderates excitement, and calms

3

What do hypnotic agents do?

Produces drowsiness and facilitates the onset and maintenance of a state of sleep

4

How is GABA modulated?

Allosterically modulated by a number of nearby receptors

5

What is the MOA for benzos?

Increase the frequency of Cl channel opening through allosteric modulation, allowing influx of Cl ions

6

How do benzos enhance GABA's effect?

Allosterically modulates the GABA A receptor binding site, which in turn modulates the chloride channel

7

What are the most common SEs of typical benzo use?

Sedation
Drowsiness
Memory difficulties
Fatigue
Muscle relaxation/weakness

8

What are the side effects of an overdose of benzos?

Over sedation
Confusion
Dysarthria
Diplopia
Ataxia
Lethargy
Dizziness
Difficulty breathing

9

What are the contraindications/wanrings to benzos?

Hypersensitivity
Acute narrow angle glaucoma
Sleep apnea
Severe respiratory insufficiency
Use of concomitant CNS depressants
Patients with h/o drug dependence
Abrupt withdrawal
Falls and mental alertness

10

What are benzo withdrawal symptoms?

Anxiety
Agitation
Insomnia
Restlessness
Muscle tension
Irritability

11

What is considered long term use of benzoes?

1+ years

12

If a patient is using benzos for at least 2-6 months, what is the tapering schedule for discontinuation?

Slow taper by decreasing dose 10-25% every 4 weeks

13

What part of benzo withdrawal is paramount?

Patient education and careful monitoring

14

What is the MOA of anxiolytics?

5-HT1a partial agonist
5-HT2 agonist

15

What is an anxiolytic?

Buspirone

16

What is the onset of buspar?

Delayed (2+ weeks)
Don't use PRN

17

What is Buspar approved for?

Approved for GAD

18

What is Buspar off label for?

Depression augmentation

19

Which drugs are key mood stabilizers?

Lithium
Valproate
Carbamazepine
Oxcarbazepine
Lamictal

20

Which drugs are other agents that work as mood stabilizers?

Pregabalin
Gabapentin
Keppra
Topiramate

21

Which mood stabilizer were not shown to have an increased risk of suicidality?

Lithium

22

Which mood stabilizers are NTIs?

Lithium
Carbamazepine

23

What is lithium's mechanistic consideration?

Alter cation transport
Neurotransmitter reuptake
Effects on second messenger systems

24

How is lithium adjusted?

CrCl < 50 (but must be stable)

25

When are lithium troughs drawn?

8-12 hours post dose

26

What is the therapeutic range for lithium in acute mania?

0.8-1.2

27

What is the therapeutic range for lithium for prophylaxis?

0.6-1.0

28

What baseline labs must be taken before lithium treatment?

BUN, SCr, Thyroid function tests, ECG if patient > 40 or hx, CBC

29

What are the most common SE of Lithium?

Thirst
Increased urination
Tremor
Wt gain
Acne
Hypothyroid
WBC elevation

30

What are neurologic toxicity symptoms of lithium?

Coarse tremor
Ataxia
Confusion
Visual changes