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33 Cards in this Set
- Front
- Back
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what is your chronic therapy for anxiety disorders |
SSRIs = first line tricyclic antidepressants = second line |
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what are the benzodiazepines |
alprazolam (Xanax)- short T1/2 Clordiazepoxide (Librium)- delirum tremens Clonazepam (Klonopin)- long T1/2 Clorazepate (Tranxene-T)- turns into diazepam Diazepam (Valium)- muscle relaxant Lorazepam (Ativan)- tx for seizures, for old ppl Oxazepam |
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MOA for benzodiazepines |
works on GABA to open Cl channels |
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what is the benzodiazepines used for as skeletal muscle relaxation |
diazepam |
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what bad effect can benzodiazepines have? |
amnestic effect |
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what is the benzodiazepines that are used for seizures |
lorazepam (Ativan) for status epilepticus clonazepam (Klonopin) in petit mal |
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what is really important to remember when taking pts off benzodiazepines |
need to TAPER slowly, like months nasty withdrawal symptoms |
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who are bad candidates for benzodiazepines |
people who have dependent behaviors |
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ADR of benzodiazepines |
-CNS: ataxia, cognitive dysfunction, depression, dizziness, drowsiness, fatigue, irritability, memory impairment, sedation -endocrine: decreased libido, weight gain, weight loss -GI: change in appetite, constipation, xerostomia -Respiratory: nasal congestion |
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dose for benzodiazepines |
Xanax 0.5mg q8h |
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what is the non-benzodiazepines |
Buspirone (BuSpar) |
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MOA of non-benzodiazepine |
doesn't affect benxodiazepine- GABA receptor serotonin receptor partial agonist D2,3,4 dopamine antagonist (presynaptic)
takes 2 wks to work |
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ADR of non-benzodiazepine |
rare CNS: dizziness, drowsiness, confusion, anger/hostility GI: nausea
no abuse potential |
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dose for non-benzodiazepine |
Buspirone (BuSpar) 15mg BID |
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what are mood disorders characterized by |
episodes of mania hypomania major depression |
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what are subtypes of bipolar disorder |
bipolar 1: manic and mixed episodes bipolar 2: one hypomanic episode, at least 1 major depressive episode, and absence of mania and mixed episode |
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what are the lithium salts |
lithium carbonate lithium citrate |
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MOA of lithium salts |
GABA rises dopamine decreases |
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aproved and unapproved uses of lithium salts |
approved: management of bipolar disorder, tx of mania unapproved: antidepressant, aggression, PSTD, conduct disorder in children
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Kinetics of lithium salts |
renal impairment drug interactions: thiazide diuretics, NSAIDs blood monitoring: therapeutic range 0.4-1.2 mEq/L |
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ADR of lithium salts |
CNS: fine postural hand tremor and electroencephalogram changes Renal: polyuria and polydipsia Endocrine: thyroid enlargement Cardiac: very rare- elderly pts with hx of arrhythmias |
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dose for lithium salts |
Lithium carbonate ER tablet 600mg BID |
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who are the valproic acid derivatives |
divalproex divalproate valproate sodium |
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what is the approved use of valproic acid derivatives |
mania associated with bipolar disorder |
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what is the unapproved uses of valproic acid |
refractory status epilepticus diabetic neuropathy |
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kinetics of valproic acid |
children under 10 clear the drug faster renal clearance <10 LFT every month |
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ADR of valproic acid |
weight gain n/v hair loss easy bruising life-threatening pancreatitis suicide risk |
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dose for valproic acid |
Depakote ER 500mg TTT qd |
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what is the anticonvulsants |
carbamazepine (Tegretol) equetro |
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substrate of Tegretol |
CYP3A4 |
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ADR of anti-convulsants |
ataxia, dizziness, somnolence, HA hematologic: agranulocytosis, aplastic anemia, leukopenia dermatologic: stevens-johnosn syndrome |
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dose for anticonvulsants |
Equetro 400mg BID |
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how do you treat bipolar pts who are severely I'll with acute mania |
lithium + antipsychotic valproate + antipsychotic carbamazepine + antipsychotic (equally effective by itself) |
