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33 Cards in this Set
- Front
- Back
What is the first line treatment for anxiety disorders?
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SSRIs b/c they have less side effects and more rapid onset of actions
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What med is reserved for treatment-resistant conditions due to risk of hypertensive crisis?
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Monoamine oxidase inhibitors (MAOIs)
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What are the 3 main indications for benzodiazepines (BZs) an antiolytics and hypnotics?
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-Anxiety
-insomnia -seizure disorder *they may also be used for alcohol withdrawl |
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What are the downsides of using BZs?
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- associated w/impaired psychomotor function, sedation, decreased cognitive function and ataxia.
-may cause depression - lead to tolerance - may lead to dependency |
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When/how should BZs be used?
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- Short term bases to treat anxiety
- High potency BZs considered only due to to side effects or alternatives are unacceptable - If the pt is unwilling to wait 4-6wk delay response of other antidepressants |
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Which meds are used to treat panic disorders?
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Xanex
klonopin ativan |
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Which meds are used to treat Acute mania?
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klonopin
ativan |
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Which meds are used for short-term hypnotic to induce sleep?
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Restoril
PeoSom Dural Ambien Sonata |
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Which meds are used to treat muscle spasms?
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Valium
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Which meds are used to treat seizure disorders?
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IV valium
Ativan Klonopin |
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Which meds are used to treat sedative withdrawl syndromw ?
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Valium
Librium |
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Which meds are used for preoperative anesthesia?
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Midazolam (versed)
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When is klonopin used?
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Panic disorders
Acute mania seizure disorders |
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When is Ativan used?
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Panic disorders
Acute mania seizure disorders |
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When is valium used?
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Muscle spasms
Seizure disorders sedative withdrawl syndrome |
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What is the mechanism of action for BZs?
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Potentiates and intensify the action of GABA. GABA inhibits and/or reduces aggression, excitation and anxiety
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Where are BZs metabolized?
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In the liver; will need periodic liver studies.
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What are the long acting BZs, what is their half life and what is a nursing consideration pertaining to their metabolism?
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- Librium
- Transexene - Valium - Centrex Half life is 4 days therefore that can be suddenly d/c WITHOUT causing withdrawl |
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What are the short acting BZs, what is their half life and what is nursing consideration pertaining to their metabolism?
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-Xanax
-Adivan - Serax Rapid elimination therefore sudden d/c WILL cause withdrawl |
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What are the side effects of BZs?
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2 most important
-Confusion - Anterograde amnesia (unable to form new memories) CNS side effects -Psychomotor impairment, drowsiness - Muscle weakness, ataxia, vertigo - Older adults more susceptible to side effects -Cognitive impairment, sedative effects *Combined with other CNS depressants may cause resp depression *NO alcohol; potentates sedation |
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What should you teach a pt about BZs?
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-Do not increase dosage
- Causes reduced ability to work mechanical equipment - Avoid caffeine and alcohol - Avoid pregnancy & breast feeding -Stopping usage after 3-4mo may cause withdrawl - Take with food, avoid antacids (delays absorption) |
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What are some contraindications for BZs?
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-Driving, being around machinery
- pregnancy - substance abuse - glaucoma - alcohol or CNS depressant users |
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What is a non-BZ used to treat anxiety and the advantages and disadvantages?
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Buspirone (BuSpar)
-does not cause sedation - no abuse potential - does not enhance CNS depression - does not interact with other drugs except MAOIs and Haldol -takes several weeks to become effective; cannot be used as a PRN |
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What are indications for BuSpar?
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-Anxiety: general anxiety disorder (GAD) and/or anxiety accompanying depressive symptoms
- Augments response to antidepressants - Treats OCD Reduce aggression in pt w/brain damage |
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What are the adverse affects of BuSpar?
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-dizziness, drowsiness, headache, excitability
- Nausea, dry mouth, diarrhea, constipation |
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What classification/drugs are used to treat ADHD?
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Stimulants such as Methylphenidate (Ritalin, Concerta, Metadate-ER, Adderall, Dexadrine)
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What are the contraindications for stimulants?
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-glaucoma
-motor tics -severe depression -use cautiously in pt w/seizure disorders (lowers threshold) |
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What are side effects of methylphenidate?
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-nervousness
- insomnia (give last dose before 6pm) -Anorexia (take with food or after eating) - Nausea - increased/decreased HR & BP - Tachycardia -Use cautiously with other meds |
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What are nursing considerations for pt on long-term methylphenidate?
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-long term problem is growth/weight suppression
- children must swallow pill whole; don't chew - Store with cautio; high street value - Avoid caffeine, chocolate and excessive sugar |
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What are the cholinesterase inhibitors and the mechanism of action?
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-Aricept
- Reminyl - Exelon -Namenda Prevents break down of ACh causing a delay in cognitive/functional decline in elderly pt w/AZ |
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What phase of AZ will cholinesterase inhibitors work and for how long?
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Only works in the mild/moderate phase (except Namenda) and improvements peaks at 3 months will slow return to previous functioning in 9-12 months
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Which drug demonstrated effectiveness in pt with moderate to severe AZ?
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Namenda
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What are some side effects of Namenda?
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-hypertension
- pain -headache - constipation -fatigue |