Cmt Prep Challenge #25

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This "shorter-acting" benzodiazepine is indicated to treat generalized anxiety disorder and panic disorder. It is available as 0.25-mg, 0.5-mg, 1-mg, and 2-mg tablets. The initial dosage to treat anxiety is 0.25 - 0.5 mg 3 times daily. The dosage may be increased every 3 to 4 days to a maximum total daily dose of 4 mg given in divided doses. The initial dosage to treat anxiety disorder is 0.5 mg 3 times daily, followed by an increase in dosage every 3 to 4 days to a maximum of total daily dosage of 10 mg per day in divided doses. Most patients treated for panic attacks require a total daily dosage between 5 mg and 6 mg. The most common adverse effects are dizziness and drowsiness, which tend to subside as treatment continues.

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Xanax (alprazolam)

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This medication is prescribed to treat schizophrenia and bipolar disorder. It is available as 2.5-mg, 5-mg, 7.5-mg, 10-mg, and 20-mg tablets. The usual initial dosage to treat patients diagnosed with schizophrenia is 5 mg to 10 mg once daily; the usual maintenance dosage is 10 mg once daily. Some patients may require a dosage of 15 mg or 20 mg once daily. To treat bipolar disorder, the usual initial dosage is 10 mg to 15 mg once daily; the maintenance dosage ranges from 5 mg to 20 mg daily. Common side effects may include dizziness, somnolence, dry mouth, increased appetite, and weight gain. Extrapyramidal symptoms (such as those seen in Parkinson's disease) may also occur, especially with higher dosages.

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Zyprexa (olanzapine)

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A patient who is suffering from insomnia related to post traumatic stress syndrome may benefit from this extended-release nonbenzodiazepine sleep aid. It is available as 6.25-mg and 12.5-mg tablets. The recommended dosage for adults is 12.5 mg taken immediately before bedtime. In patients who are elderly, debilitated, or who have hepatic insufficiency, the recommended dosage is 6.25 mg taken immediately before bedtime. The tablets must be swallowed whole, and not crushed or chewed. Side effects may include headache, dizziness, and daytime somnolence.

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Ambien Cr (zolpidem)

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This selective serotonin reuptake inhibitor (SSRI) is indicated to treat major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, and panic disorder. It is available as 10-mg, 20-mg, and 40-mg capsules. The usual dosage to treat depression is 20 mg once daily in adults, and 10 mg to 20 mg once daily in children. The dose should be taken in the morning. It may take as long as 4 to 6 weeks to see an improvement in symptoms. The dosage to treat obsessive-compulsive disorder ranges from 20 mg to 80 mg daily; the dosage may be given once daily or divided into 2 doses per day. The dosage to treat bulimia nervosa is 60 mg once daily in the morning; and the dosage to treat panic disorder may range from 10 mg to 60 mg daily, starting with 10 mg once daily, increasing the dosage to 20 mg once daily after 1 week. Common side effects may include nervousness and insomnia. This medication has a black box warning stating an increased risk of suicidal thinking and behavior in children and adolescents being treated for major depressive disorder. Children and adolescents who are taking this medication must be monitored for suicidal or unusual behavior. At the end of treatment, this medication must be reduced gradually to minimize the risk of a relapse in symptoms.

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Prozac (fluoxetine)

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This medication may help control the manic phase in patients diagnosed with bipolar disorder. It is available as 300-mg extended-release tablets. The dosage for acute mania is 3 tablets in the morning and 3 tablets in the evening, or 2 tablets 3 times daily. The maintenance dosage is 2 tablets in the morning and 2 tablets in the evening. Side effects that may occur during the first few days of treatment may include fine hand tremor, mild thirst, nausea, and polyuria-all which tend to subside with continued treatment. The patient's lithium blood levels must be monitored to avoid toxicity, which is associated with side effects such as drowsiness, dizziness, muscle weakness, lack of coordination, diarrhea, and vomiting.

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Lithobid (lithium carbonate)

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This benzodiazepine is used to manage panic attacks. It is available as 0.5-mg, 1-mg, and 2-mg tablets, and as 0.125-mg, 0.25-mg, 0.50-mg, 1-mg, and 2-mg wafers (orally disintegrating tablets). The initial dosage is 0.25 mg twice daily titrated up to a maintenance dosage of 1 mg per day. Tablets should be swallowed whole with water. Patients who are using the wafers are instructed to open the foil, use dry hands to take the wafer out of the packing, and put it on their tongue. The wafer dissolves rapidly in saliva, so patients can swallow it without water. Common adverse effects may include drowsiness and dizziness. Like other benzodiazepines, stopping the medication abruptly may result in seizures. To discontinue treatment, the dosage should be reduced by 0.125 mg twice daily.

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Klonopin (clonazepam)

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This medication may be prescribed for children, adolescents, and adults to manage symptoms associated with attention deficit hyperactivity disorder. It is available as 5-mg, 10-mg, 15-mg, 20-mg, 25-mg, and 30-mg capsules. The initial dosage in children age 6 and older and in adolescents ages 13-17 is 10 mg once daily in the morning. The dosage for children may be increased by 5 mg or 10 mg weekly until the appropriate dosage is achieved. The dosage for adolescents may be increased to 20 mg daily after the first week. The recommended dosage for adults is 20 mg daily. The medication may be swallowed whole, or patients may open the capsule and sprinkle the contents on their food (which must be eaten right away). Common side effects may include abdominal pain (stomachache), loss of appetite, and insomnia. Hypertension in adolescent patients has also occurred. To minimize insomnia, patients should take this medication in the morning, as soon as they wake up.

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Adderall XR (dextroamphetamine salts)