Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

35 Cards in this Set

  • Front
  • Back
What anxiety disorders can be treated with SSRIs and Benzos?
1. GAD
2. panic disorder
4. OCD
5. social anxiety disorders
3 things to consider in choosing a Benzo for anxiety?
1. rapidity of onset of action
2. duration of action
3. half-life and route of metabolism
Other therapeutic effects for Benzos?
1. anticonvulsant (clonazepam, nitrazepam, diazepam)
2. anesthesia (diazepam and midazolam - both have rapid onset; give IV as adjuncts)
3. muscle relaxation (diazepam)
4. sleep disorders - for induction or maintenance of sleep
What must you do first before prescribing drugs for insomnia?
essential to first establish the etiology of the disorder
What drugs are specifically approved for treatment of insomnia?
1. estazolam
2. temazepam
3. quazepam
4. flurazepam
5. triazelam
What 4 problems can benzos and all sedative-hypnotics produce?
1. dependence
2. tolerance
3. addiction
4. withdrawl symptoms
What factors influence whether someone taking benzos/other sedatives develops addiction, tolerance, dependence, and withdrawl?
1. rapidity of onset of drug - more rapid onset means greater potential for abuse
2. potency
3. dose of drug taken
4. half-life
5. length of time drug is taken
More severe withdrawl from sedatives occurs with:
1. higher doses
2. higher duration of use
3. higher potency
4. shorter half-life
5. shorter time of onset
When can sedative-hypnotics be fatal?
abrupt discontinuation of drug
Strategy for discontinuation of sedatives?
1. taper
2. switch to longer half-life drug, preferably w/ lower potencyand less rapid onset
Why do non-benzos show less S/Es than benzos?
less CNS depression (even in overdose)
What drug class shows less CNS depression and can be used to treat sleep disorders? What are the drugs? (3)

What inhibits the metabolism of Zaleplon?**
OTC H2-histamine receptor blockers (Cimetidine)
What drug can block the effect of zolpidem and zaleplon?*
flumazenil (a benzodiazepine antagonist)
How does the indication for eszopiclone differ from the others in its class?
Eszopiclone can be used long-term (the other two drugs are short-term)
MOA: Mirtazapine?
alpha-2 adrenergic receptor antagonist --> increases release of NE and 5-HT

also blocks 5-HT receptors
**Paradox with Mirtazapine?**
at low dose, Mirtazapine is highly sedating; increasing doses --> less sedating**
MOA: Amitriptyline?

special use?
TCA w/ high affinity antagonist actions at H1 and H2 histamine receptors

use: treat sleep disorders assoc w/ or contributing to chronic pain disorders (i.e. fibromyalgia)
Why must tricyclic antidepressants NOT be prescribed for elderly (>65)?
induce a toxic and confused state
What are three H-1 histamine receptor antagonists used for sleep disorders?
Diphenhydramine (OTC - Benadryl)
Which sleeping pill is highly sedating at LOW doses?
MOA: Diphenhydramine?
=Benadryl (OTC); H-1 histamine receptor antagonist
**MOA: Nefazodone?**

Why might people really like this med?
**5-HT2A receptor antagonist and 5-HT reuptake inhibition**

mildly sedating and doesn't interfere w/ sexual fxn
Trazadone use?
originally as an antidepressant, is highly sedating so now used as hypnotic drug
How effective are non-prescription "sleeping pills"?

What are some potential problems with them?
many are not more effective than placebo

may cause tolerance and rebound insomnia
Herbal drugs for insomnia?
What is a benzo that is commonly prescribed for "insomnia", but is not approved for it?
What non-benzos are approved for treatment of sleep disorders?
What needs to be considered when prescribing Benzos for the elderly?
half-lives are longer in elderly patients b/c they metabolize drugs more slowly
**Which Benzos are most likely to suffer from age-related effects on half-lives?** Why?
Those that are more likely to be converted into active metabolites:

**Which Benzos are LEAST likely to be affected by age-related effects on drug half-lives? Why?**
Those that are only conjugated by the liver (no active metabolites):

What is the common active metabolite of many Benzos?
**What may happen if a Benzo for insomnia is stopped?**
rebound insomnia**
When does rebound insomnia occur?
when a Benzo is stopped

recurrence of original symptoms or symptoms greater than the original
Which has a greater risk of abuse, dependence, and withdrawl, BZs or barbituates?