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19 Cards in this Set
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Antianxiety agents
Benzodiazepines What do they end in? There are 7, name as many as you can. What is their MOA? (same for all) What are AE? (same for all) |
Antianxiety agents
Benzodiazepines All end in -am, some -pam, some -lam -pam Lorazepam (Ativan) Diazepam (Valium) Clonazepam (Klonopin) Temazepam (Restoril) Flurazepam -lam Alprazolam (Xanax, Niravam) Triazolam (Halcion) Estazolam MOA: Potentiates actions of endogenous GABA at the GABA receptor/chloride ion channel complex AE:CNS depression, drowsiness, incoordination, weak respiratory depression, low abuse potential |
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Which benzodiazipines are used for insomnia?
Hint: There are 4, 2 -pam, 2 -lam |
BZDs for insomnia:
Temazepam (Restoril) Flurazepam Triazolam (Halcion) Estazolam |
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Which benzodiazipines are used for Generalized Anxiety Disorder & panic attacks? (3)
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BZDs for GAD and panic:
Alprazolam (Xanax, Niravam) Diazepam (Valium) Lorazepam (Ativan) |
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What BZDs have fast onset? (4)
Which of them are long acting? (4) Which of them have intermediate length duration? (3) Which is short acting? (1) |
Fast acting:
Diazepam (Valium) Temazepam (Restoril) Alprazolam (Xanax, Niravam) Triazolam (Halcion) Flurazepam Long acting? Diazepam (Valium) Clonazepam (Klonopin) Flurazepam Estazolam Intermediate length of duration? Alprazolam (Xanax, Niravam) Lorazepam Ativan Temazepam (Restoril) Short acting? Triazolam (Halcion) |
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Which BZDs have active metabolites?
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Alprazolam (Xanax, Niravam)
Clonazepam (Klonopin) Diazepam (Valium)-2 active mets |
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Flumazenil (Romazicon)
Class? Indication? MOA? AE? |
Class: BZD antagonist
Indication: reversal of BZD effects MOA: BZD derivative that antagonize CNS depressant effects at same receptor AE: seizure, dizziness, N/V, HTN, flushing, arrythmias |
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"BZD-like" drugs/anti-anxiety
Zolpidem (Ambien) Zaleplon (Sonata) Eszopiclone (Lunesta) Indication? MOA? AE? Which 1 is longer acting? |
Zolpidem (Ambien)
Zaleplon (Sonata) Eszopiclone (Lunesta) Indication: Insomnia, induction of sleep MOA: Bind to BZD receptor site of the GABA/chloride ion channel complex (only found in CNS) AE: daytime drowsines, dizziness, N/D/V, anaphylactic reactions Eszopiclone (Lunesta) is longer acting. Ambien & Sonata have shorter 1/2 lives |
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Buspirone (Buspar) is a non-BZD antianxiety agent
Indication? MOA? AE? |
Indication: relief of anxiety, slower onset of anxiolytic activity, does not produce dependence, no abuse potential, no additive effects w/ other CNS depressants
AE: dizziness, drowsiness, fatigue, headache, insomnia, tinnitus, tachycardia, chest pain, rashes MOA: Partial 5HT-1 agonist, binds to serotonin and DA receptors in CNS |
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Barbituates (4)
MOA? (same for all) AE? (same for all) Hint: 3 end in -tal, 4th in -al and is 2 words |
Phenobarbital (Luminal)
Secobarbital (Seconal) Thiopental (Pentothal) Chloral hydrate (Aquachloral, Suprettes, Somnote) MOA: CNS depressants, act at GABA/chloride ion channel complex to bind to BZD receptor site " AE:respiratory depression, suicide, hyperalgesia, drug interactions result frm induction of CYP 450 enzyme, additive effects w/ other CNS depressants |
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Phenobarbital (Luminal)
Class? Indication? Onset & duration? Schedule? (Class II, III, IV, etc) |
Class: Barbituates
Indication:Seizures fast onset(0.5min) short duration (20min) Schedule: Class IV |
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Secobarbital (Seconal)
Class? Indication? Onset/duration? Schedule? |
Class: Barbiturate
Indication: insomnia 10-15 min onset 3-4 hrs duration Schedule: II (high potential for misuse) |
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Thiopental (Pentothal)
Class? Indication? Onset/duration? Schedule? |
Class: Barbiturate
Indication: induction of anesthesia, seizures 60 min or less onset 10-12 hrs duration Schedule: Class III |
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Chloral hydrate (Aquachloral, Suprettes, Somnote)
Class? Indication? Onset/duration? Schedule? |
Class: Barbiturate
Indication: Short term sedation; sedation, induction of sleep Fast onset, short acting Schedule: Class IV |
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Amitriptyline (Elavil)
Desipramine (Norpramin) Nortriptyline (Pamelor) Note: all end in -ine Common therapeutic use? Class? MOA? Biggest concern? CI? AEs? Which 2 are secondary amines? |
Amitriptyline (Elavil)
Desipramine (Norpramin) Nortriptyline (Pamelor) Indication: antidepressants, used to treat neuropathic pain Class: Tricyclic antidepressants (TCAs) "-ine suffix" MOA: prevent removal and potentiates effect of serotonin and NE in CNS, significant anticholinergic effect **Black box warning for increased suicide risk** CI: Do not use with alcohol AE: constipation, seizure inducing, sedation, orthostatic HTN, CNS depressant, drug interaction w/ CYP 450 enzyme, arrythmias in the heart, cardiac toxicity Desipramine (Norpramin) & Nortriptyline (Pamelor) are secondary amines; Amitriptyline (Elavil) is a tertiary amine |
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Tranylcypromine (Parnate)
Phenelzine (Nardil) Common therapeutic use? Class? MOA? CI? AEs? |
Tranylcypromine (Parnate)
Phenelzine (Nardil) Indication: Antidepressants, improve mood Class: MAO inhibitors MOA: inhibit monoamine oxidase from breaking down monoamines, increase concentrations of DA, NE, SR in synaptic clefts CI: Lactation AE: seizures, HTN, headache, abdominal pain ,tinnitus |
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Fluoxetine (Prozac)
Paroxetine (Paxil) Sertraline (Zoloft) Citalopram (Celexa) 1st line agents Common therapeutic use? Class? MOA? Watch for? AEs? Which one is FDA approved for anxiety? |
Fluoxetine (Prozac)
Paroxetine (Paxil) Sertraline (Zoloft) Citalopram (Celexa) *Note 3/4 end in -ine" Indication: Antidepressants Class: SSRI (Selective serotonin reuptake inhibitor) MOA: block reuptake of 5HT (serotonin) Watch for Serotonin syndrome If stopping med, watch for withdrawal symptoms (agitation, anxiety, sleep/eating pattern change) AE: Sexual dysfunction, hypothermia, weight gain, N/V/D, bleeding, serotonin syndrome, muscle spasms, confusion, sweating paroxetine (Paxil) is FDA approved for anxiety, OCD, panic attacks |
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Duloxetine (Cymbalta)
Venlafaxine (Effexor) Common therapeutic use? Class? MOA? Watch for? AEs? |
Duloxetine (Cymbalta)
Venlafaxine (Effexor) Indication: Antidepressants; Decrease symptoms of depression, anxiety, neuropathic pain. Effexor indicated for "fewer relapses" Class: SNRI (Selective norepinephrine reuptake inhibitor) MOA:Inhibit serotonin and NE reuptake in CNS Watch for: serotonin syndrome AE: sexual dysfunction, hepatotoxicity, constipation, N/D/V, fatigue, seizure, insomnia, HTN, sweating, dysuria, serotonin syndrome, dry mouth |
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Nefazodone (Serzone)
Mirtazapine (Remeron) Common therapeutic use? MOA? AEs? |
Nefazodone (Serzone)
Mirtazapine (Remeron) Indication: antidepressant; Decrease depression MOA: Mixed serotonin and NE reuptake AE: Seizures, suicide, headache, dry mouth, tremor, N/V |
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Bupropion (Wellbutrin)
Common therapeutic use? MOA? AEs? |
Bupropion (Wellbutrin)
Indication: antidepressant; Decrease depression MOA: Acting through DA, blocks DA reuptake at receptors AE: Seizures, suicide, headache, dry mouth, tremor, N/V Also marketed as Zyban for smoking cessation |