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182 Cards in this Set
- Front
- Back
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What does a sedative effect imply ?
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refers to the ability of these agents to calm or reduce anxiety, known as an anxiolytic effect
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What does a Hypnotic effect imply ?
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Hypnotic describes the ability of these agents to induce drowsiness and promote sleep. caused by a greater depression of CNS activity and most sedative-hypnotic drugs will first cause sedation, then at higher doses, produce hypnosis
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What is chronic anxiety
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Characterized by changes in mood (apprehension and fear), sympathetic nervous system arousal, and hypervigilance.
When anxiety becomes chronic, it can impair a person's ability to perform ADL’s. activities of daily living Chronic anxiety often leads to visceral organ dysfunction and unpleasant symptoms |
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Neuronal pathways involved in anxiety disorders
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sensory, cognitive, behavioral, motor, and autonomic pathways
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What class is useful for short term relief from severe acute anxiety
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Benzodizepines
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Panic disorder sx
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Acute episodes of severe anxiety with marked psychologic and physiologic symptoms
an individual may feel an impending sense of doom that is often accompanied by sweating, tachycardia, tremor, and other visceral symptoms. |
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Panic disorder tx
& Phobia |
Benzo or an SSRI
Alprazolam (XANAX) and Clonazepam (KLONOPIN) short term Sertraline chronic |
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Stage Fright
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Propanolol
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OCD tx
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Sertraline
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GAD sx
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Chronic worry and apprehension concerning future events.
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GAD tx
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Benzo = short term and intermittent
Busiprone = non sedating anziolytic for chronic anxiety. No tolerance or dependance. SSRI = Long term tx with Paroxetine |
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PTSD
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Chronic = SSRI
Acute = Benzo |
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Management of insomnia depends on what 3 factors ?
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depends on whether the sleep disorder is caused by physiologic, psychologic, or medical conditions.
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Insomnia caused by medical conditions tx
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Benzodiazepines
or Zolpidem Zapelon |
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Benzodiazepines effect on sleep
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Decrease sleep latency and increase sleep duration
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Drugs of choice for insomnia
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zolpidem, (ambien) zaleplon,(sonata)
eszopiclone, (lunesta) ramelteon, (rozerem |
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Why are drugs like Zolpidem preferred for sleep disorders
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not significantly affecting sleep architecture and not causing as much tolerance and dependence as do the older drugs
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Sedative Hypnotic Drugs
List the classes |
benzodiazepines, barbiturates, some antihistamines, and a few nonbenzodiazepine agents, such as zolpidem, zaleplon, eszopiclone, and ramelteon
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Benzodiazepines
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Dose dependent depression of CNS
Lower doses have a sedative and anxiolytic effect, whereas higher doses produce hypnosis (sleep) and anesthesia Can produce Anteriograde amnesia, NOT retrograde. |
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Alcohol + Benzo causes
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Significant respiratory depression, coma and death.
Without alcohol theses SA will not occur , this is called the ceiling effect. |
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Do barbituates have a ceiling effect like the Benzodiazepines
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No
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Benzodiazepine indications
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Anxiolytic, hypnosis
Anticonvulsant effects and are used in the treatment of seizure disorders Muscle spasm and spasticity Alcohol withdrawal IV most potent Mild euphoric effect and long term physical dependance can occur Withdrawal from long term use should be tapered |
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The adverse effects of Benzodiazepines are caused by what ?
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Dose limited but excessive CNS depression
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What is administered to counteract Benzodiazepine overdose
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Flumazenil
A benzodiazepine receptor antagonist IV - Rapid Onset - Short Duration |
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Alprazolam
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Benzodiazepam
XANAX Used for Anxiety medium duration of action |
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Chlordiazepoxide
Diazepam |
Benzodiazepine
converted to long-acting metabolites; Anxiety Alcohol Detoxification |
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Diazepam
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Benzodiazepine
VALIUM long acting metabolite Anxiety Alcohol detoxification terminate acute recurrent siezures, severe muscle spasm caused by degenerative and demyelinating neurologic disorders |
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Barbituates Drug List
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amobarbital, pentobarbital, phenobarbital, and thiopental
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How do benzodiazepines and barbituates affect sleep
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They suppress slow wave and REM sleep.
Barbituates can cause hangover and daytime sedation |
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What is the effect of Barbiturates
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Anxiolytic effect associated with considerable sedation
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Abuse of Barbiturates
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Tolerance and physical dependence during continuous use
Withdrawal syndrome occurs if abruptly discontinued Short-acting barbiturates (e.g., pentobarbital) have been extensively abused |
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Barbiturate Indications
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Anxiolytic
Insomnia seizure disorders and for the induction of general anesthesia |
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What barbiturates would you use to treat insomnia
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Amobarbital and Pentobarbital
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What is Phenobarbital used for
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Occasionally for seizure disorders
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What is Thiopental used for
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Barbiturate
Administered IV for anesthesia |
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What are antihistamines used for psychologically
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OTC for sleep and anxiety
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SA Of Barbiturates, Why compared to benzodiazepines
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Dose dependent CNS depression
Respiratory depression, coma, death The barbiturates exhibit greater toxicity and smaller therapeutic index than the benzodiazepines |
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Barbiturate most likely to be abused
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Phenobarbital
Because it is short acting |
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Would you use a Benzodiazepam or a Barbiturate for muscle relaxation ?
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You will use a Benzodiazepam
The barbiturates do not produce muscle relaxation and are not used in for muscle spasm |
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What are the Indications for Benzodiazepines
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Anxiety
Insomnia Muscle Spasm Seizure Spasticity Alcohol Withdrawal Anteriograde Amnesia |
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What are the indications for Barbiturates
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Anxiety
Insomnia seizure disorders anesthesia |
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What are the newer Other Sedative Hypnotics
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Zolpidem
Zapelon Ezopiclone |
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Why are The newer other sedative hypnotics preferred over benzodiazepines
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Less adverse effects
less tolerance and dependence potential Shorter duration of action = Less daytime sedation and hangover These are due to more accurate receptor binding ( While the benzo affect a large group = larger range of SA) |
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Zolpidem Trade name
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Ambien
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Zapelon Trade name
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Sonata
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Eszopiclone trade name
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Lunesta
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What is the advantage of zapelon over the other new sedative hypnotics
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its elimination half-life is the shortest at about 1 hour and can be taken in patients that awaken in the middle of the night and have difficulty going back to sleep.
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Melatonin
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Neuroendocrine hormone from the pineal gland, used for jet lag and insomnia in shift change workers
Non FDA approved |
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Ramelteon ( Rozerem )
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new drug that acts at selective melatonin receptors and is approved to treat sleep-onset insomnia. not appear to produce dependence and shows little potential for abuse. no evidence for rebound insomnia. currently the only nonscheduled prescription drug for insomnia
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Chloral Hydrate
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Potentiated by alcohol, and the combination of alcohol and chloral hydrate gained fame under the monikers of "Mickey Finn" and "knock-out drops.“
Occasionally used for preanesthetic sedation in pediatric patients. |
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Buspirone
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Is a NON sedating Anxiolytic
Unique anxiolytic agent, no structural similarity with others Used for Chronic Anxiety produces an anxiolytic effect without marked sedation, amnesia, tolerance, dependence, or muscle relaxation Buspirone is a partial agonist at serotonin 5-HT1A receptors and may exert its anxiolytic effect by activating feedback inhibition of serotonin release. |
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What are the two major types of psychiatric disorders
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psychoses, such as schizophrenia, and affective disorders, such as depression.
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What is a psychoses
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Psychoses are disorders in which patients exhibit gross disturbances in their comprehension of reality, as evidenced by false perceptions (hallucinations) and false beliefs (delusions).
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What is an affective disorder
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Affective disorders are emotional disturbances in which the mood is excessively low (depression) or high (mania)
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What are the positive sx of schizophrenia
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delusions and hallucinations are usually the primary manifestations of acute psychotic episodes.
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What are the negative sx of schizophrenia
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apathy, withdrawal, and lack of motivation and pleasure, generally are more difficult to treat, often persist after positive symptoms resolve, and are associated with a poor prognosis.
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What are antipsychotic drugs sometimes called
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Neuroleptic drugs because they suppress motor activity and emotional expression.
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What receptors do antipsychotics work on
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Antagonism at α1-adrenoceptor
Antagonism of the Muscarinic receptors Antagonism of bran H1 receptors |
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What are the adverse effects of antipsychotic action on a1-Receptors
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dizziness, orthostatic hypotension, and reflex tachycardia.
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What are the adverse effects of antipsychotic action on Muscarinic Receptors
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Blurred vision
dry mouth constipation urinary retention |
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What are the adverse effects of antipsychotic action on Brain H1 receptors
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Drowsyness and weight gain
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What is the most disturbing adverse effect of antipsychotic administration . What is an example ?
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development of motor abnormalities following the administration of high-potency, typical types
Neuroleptic Malignant syndrome ex. |
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What is neuroleptic Malignant Syndrome
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a severe form of drug toxicity that occurs in 0.5% to 1% of patients treated with antipsychotic drugs. It is a life-threatening condition characterized by muscle rigidity, elevated temperature (>38° C), altered consciousness, and autonomic dysfunction (tachycardia, diaphoresis, tachypnea, and urinary and fecal incontinence
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Indications for antipsychotics
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Schizophrenia and other forms of psychosis, including drug-induced psychosis and psychosis associated with the manic phase of bipolar disorder
Severely agitated patients, those with dementia and severe mental retardation the phenothiazines have antiemetic activity, some used for nausea and vomiting |
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What receptors do typical antipsychotics work on primarily
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The d2 dopamine receptors
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What receptors do Atypical antipsychotics work on primarily
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The 5-HT seratonin receptors
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How is neuroleptic malignant syndrome treated
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Immediately discontinuing treatment and administering Dantrolene to prevent further muscle abnormality
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Four major typical antipsychotics
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Chlorpromazine, (thorazine), fluphenazine,
thioridazine, and haloperidol (haldol). |
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What is the time required for positive symtoms to resolve from typical antipsychotic treatment
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usually subside in 1 to 3 weeks. less agitation, fewer auditory hallucinations.
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Typical antipsychotics have more effect on what type of symptom
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Positive symptoms
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Atypical antipsychotics have more effect on what type of symptom
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Negative Symptoms
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Chlorpromazine potency and type, SA info
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Low potency, Typical
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Thioridazine potency and type, SA info
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Low potency , Typical
Greater anticholinergic effects with fewer extrapyramidal side effects when compared to the other low potency drug |
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Fluphenazine potency and type , SA info
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Medium potency, typical
produces fewer autonomic side effects but more extrapyramidal side effects than do low-potency Available IV in long acting depnot preparation every 1 -3 weeks for non compliant or non oral patients |
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Haloperidol potency and type, SA info
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High potency , typical
Most widely used typical Available IV in long acting depnot preparation every 1 -3 weeks for non compliant or non oral patients Significant extrapyramidal SA |
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What antipsychoitc would be used for tourettes syndrome
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Haloperidol
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Extrapyramidal SA of typical antipsychs
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akathisia, pseudoparkinsonism, and dystonias
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What is akathisia
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motor restlessness," feel compelled to pace, shuffle their feet, or shift positions and are unable to sit quietly.
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What is pseudoparkinsonism
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resembles idiopathic Parkinson's disease and is characterized by rigidity, bradykinesia, and tremor.
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What is dystonia
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a state of abnormal muscle tension that often affects the neck and facial muscles, including the tongue, pharynx, larynx, and eyes
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What is Tardive Dyskinesia
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Disorder following months or years of treatment with antipsychotics
Characterized by abnormal oral and facial movements (e.g., tongue protrusion and lip smacking). In later stages, abnormal limb and truncal movements Many believe it results from supersensitivity to dopamine, which develops during long-term dopamine receptor antagonism |
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How to treat the extrapyramidal side effects of Typical Antipsychotics
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managed by lowering the drug dosage, changing to an atypical drug, or administering an additional drug to counteract the effects.
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Drugs to counter Acute extrapyramidal side effects
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Benztropine, (cogentin) an anticholinergic drug; Diphenhydramine, an antihistamine with anticholinergic activity; Amantadine, increases dopamine release in the basal ganglia and can be used in conjunction with an anticholinergic drug.
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What are the major Atypical antipsychotics
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Clonzapine (clozaril)
Olanzapine (zyprexa) Quietapine (seroquel) |
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What atypical antipsych requires cbc monitoring, why
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Clozapine can cause aggranulocytosis
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What is Quetiapine used for
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schizophrenia and acute manic episodes associated with bipolar disorder, as either monotherapy or adjunct therapy to lithium or valproate
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Olanzapine ( zyprexa )
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Atypical Antipsychotic
as effective as haloperidol in alleviating the positive symptoms of schizophrenia, is superior to haloperidol in alleviating the negative symptoms, and produces fewer extrapyramidal side effects |
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Olanzapine SA
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sedation and weight gain.
At higher doses akathisia, pseudoparkinsonism, and dystonias |
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Risperidone (risperdal)
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newer atypical
Similar to olanzapine, but causes less sedation, more orthostatic hypotension, and more extrapyramidal side effects than olanzapine. Its effects on treating both the positive and negative symptoms of schizophrenia are caused by antagonism at both D2 and serotonin (5-HT2A) receptors. May elevate levels of serum prolactin Lengthens the QT interval |
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What is the cardiac side effect of Risperidone
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Lengthens the QT interval, this can lead to torsades de Pointes
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Two most common affective disorders
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major depressive disorder and bipolar disorder
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What characterizes a major depressive disorder
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depressed mood, loss of interest or pleasure in life, sleep disturbances, feelings of worthlessness, diminished ability to think or concentrate, and recurrent thoughts of suicide. Depressed patients can also be irritable or anxious.
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What is bi-polar disorder
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characterized by recurrent fluctuations in mood, energy, and behavior that encompass the extremes of human experience
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What is the Biogenic amine hypothesis
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mood disorders result from abnormalities in serotonin, norepinephrine, or dopamine neurotransmission
supported by the fact that all antidepressant drugs act to increase serotonin, norepinephrine, or dopamine neurotransmission in the brain |
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Major Classes of antidepressant drugs
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Tricyclic antidepressants (TCAs),
selective serotonin reuptake inhibitors (SSRIs) Others with different properties Monoamine oxidase inhibitors (MAOIs) |
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What boxed warnings do antidepressants now carry
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the risk of increased suicidal thoughts and behavior in children, adolescents, and adults.
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Antidepressant Indications
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Some are beneficial in certain sleep disorders, including somnambulism, night terrors, and enuresis.
In enuresis, antidepressants appear to increase the awareness of the need to urinate and facilitate waking Others have a role in chronic pain syndromes because of their mood-elevating effect and analgesic activity |
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What is the antidepressant Clomipramine ( anafril ) particularly useful in treating
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OCD
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SSRI indications
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depression, eating disorders (e.g., bulimia nervosa and anorexia nervosa), and anxiety disorders ( panic, phobias and OCD)
SSRIs also effective in other conditions : fibromyalgia, autism, and premenstrual dysphoric disorder |
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TCA includes
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amitriptyline, ( elavil )
clomipramine, desipramine, imipramine, and nortriptyline |
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Is toxicity with a TCA a concern ?
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Yes, excessive doses may result in severe toxicity
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TCA kinetics and methods
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incompletely absorbed after oral administration and are metabolized to active and inactive metabolites in the liver
block the neuronal reuptake of norepinephrine and serotonin, but to differing degrees |
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How long do the TCA present active metabolites
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Long half lives, 18- 70 hours
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How long until the TCA treatment effect is apparent
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2 -4 weeks after starting
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What are the TCA SA and how are they caused
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autonomic side effects by blocking muscarinic and α1-adrenoceptors. Some produce marked sedation.
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What is the result of a TCA overdose
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life-threatening cardiac arrhythmia, which frequently presents as a wide QRS complex tachycardia; marked autonomic effects, including hypotension and sinus tachycardia; excessive sedation; and seizures.
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How are the overdose effects of a TCA treated
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The cardiac affects following overdose are treated with Sodium Bicarbonate
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What are the tertiary amines
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Amitriptyline, clomipramine, and imipramine
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What are the secondary amines
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nortryptiline, desipramine
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Of the TCAs what are the differences between primary and secondary
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tertiary amines block serotonin reuptake to a greater extent than do secondary amines.
Produce more sedation and autonomic side effects than do secondary amines. (nortryptiline, desipramine) *TCAs are equally effective in relieving depression, although some respond better to one drug than to another. |
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How to choose between TCA
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Choose the most fitting side effects for each patient
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What major drugs are included in the SSRI
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fluoxetine, (prozac)
fluvoxamine, paroxetine, (paxil ) sertraline, (zoloft ) citalopram, escitalopram. |
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Indications for SSRI
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most widely used drugs for the treatment of depression and certain anxiety disorders, such as panic disorder and obsessive-compulsive disorder.
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Compare TCA and SSRI
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As effective as the TCAs but fewer autonomic side effects and less sedation
Much safer than the TCAs following an overdose As opposed to older TCA agents that also block both serotonin and norepinephrine reuptake but also interact with many other receptor types to produce adverse effects, new drugs that are selective for both of the reuptake transporters, but not other receptors, are now available. |
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Duloxetine (cymbalta )
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potent and selective inhibitor of both neuronal serotonin and norepinephrine reuptake. major depressive disorder, diabetic peripheral neuropathic pain, and generalized anxiety disorder , fibromyalgia.
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What are the two SNSRI
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Duloxetine ( cymbalta )
Venlafaxine ( Effexor ) |
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What does SNSRI stand for
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selective serotonin norepinephrine reuptake inhibitors
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Time of administration for TCA vs SSRI
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TCAs before bed PM
SSRIs are usually administered in the AM, tending to increase alertness. |
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SSRI S/A
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Common adverse effects are nervousness, dizziness, and insomnia.
Male sexual dysfunction: priapism( undesired erections) and impotence. Most side effects subside with continued use. |
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When to take caution in using an SSRI
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seizure disorders, hepatic disorders, diabetes, or bipolar disorder.
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Why should an SSRI be used with caution in a pt with seizure history
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The drug class lowers the seizure threshold
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Fluoxatine ( prozac) indications
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depression, and the first drug approved for bulimia nervosa; effective in anorexia nervosa.
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Fluoxatine ( Prozac ) moa and interactions
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Well absorbed orally and converted to an active metabolite. The parent compound has a half-life of 2.5 days, but its active metabolite has a half-life of about 8 days. This long duration of action can be a disadvantage if severe adverse effects occur.
Fluoxetine causes more drug interactions than do other SSRIs. It can impair the regulation of blood glucose levels in diabetic patients. It can also cause a syndrome of inappropriate antidiuretic hormone secretion, characterized by persistent hyponatremia and elevated urine osmolality. High effect on P450 enzymes. Many drug interactions |
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Fluvoxamine ( luvox ) Indications, moa
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obsessive-compulsive disorder but has also been used to treat depression and panic disorder.
Half-life of about 15 hours Sedative effects |
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Paroxetine ( Paxil )
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Depression
21 hour half life high bioavailabilty more sedating than Citalopram and Escitalopram |
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Sertaline ( zoloft )
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depression
26 hour half life low bioavailability, extensive first pass elimination |
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What SSRI is preferred in elderly patients
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Sertraline may be preferred in elderly patients because its elimination is not affected substantially by aging.
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Citalopram ( Clexa )
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has chemical structure unrelated to that of other SSRIs or of tricyclic, tetracyclic, or other available antidepressant agents.
It is a racemic mixture (contains both R and S enantiomers of the drug molecule) and highly selective for serotonin reuptake transporters |
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Escitalopram ( lexapro )
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pure S-enantiomer (single isomer) of the racemic citalopram drug; is at least 100 times more potent than the R-enantiomer with respect to inhibition of 5-HT reuptake
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MAOI stands for
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Monoamine Oxidase Inhibitors
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About MAOI
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Many potentially serious interactions with other drugs and food
Not drugs of choice in depression Alternative therapy when patients have failed to respond adequately to other drugs |
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MAOI method of action
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Bind irreversably to the enzyme monoamine oxidase responsible for the degradation of biogenic amine neurotransmitters
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What are the biogenic amine neurotransmitters and what drug class prevents there oxidation
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NE, Dopamine, Seratonin
MAOI class |
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What food types seriously interact with MAOI
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Foods containing tyramines, cheese, beer, wine, meat and fish, some fruits and vegitables such as raisins
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What is the major side effect of the MAOI
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Sometimes fatal hypertensive crisis
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Selegiline
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third type of MAOI, which selectively inhibits MAO-B and is also used in the treatment of Parkinson's disease
recently approved for the treatment of depression in a transdermal patch formulation called EMSAM. |
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What MAOI drug was recently converted to a patch to treat depression
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Selegiline, the patch is called EMSAM
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Bupropion (wellbutrin)
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Other antidepressants
adjunct therapy for patients who are attempting to quit smoking cigarettes |
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Mirtazapine (remeron)
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Other antidepressants
antidepressant and antianxiety effects |
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Trazodone
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selectively inhibits the neuronal reuptake of serotonin. Can be used additively for sedation effect.
Causes considerable sedation and orthostatic hypotension, but no anticholinergic side effects and has minimal effects on cardiac conduction. |
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Venlafaxine ( effexor )
Duloxetine ( cymbalta ) |
structurally unique antidepressants that strongly inhibit the reuptake of both norepinephrine and serotonin. Both have a side effect profile similar to that of the SSRIs.
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Hypercin
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Extracts of the plant called St. John's wort (Hypericum perforatum)
Antidepressant activity similar but weaker to SSRI |
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SSRI interactions
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Warfarin
Triptan can increase the hypoprothrombinemic effect of warfarin. Serotonin syndrome when used with a MAOI Also the combined use with triptan used to treat migrane may cause serotonin syndrome as well |
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What is serotonin syndrome
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SSRI combined with an MAOI
because both increase the serotonin levels in the brain and their concurrent use can precipitate the serotonin syndrome. This syndrome is characterized by agitation, restlessness, confusion, insomnia, seizures, severe hypertension, and gastrointestinal symptoms. At least 2 weeks should elapse between the discontinuation of treatment with either an MAOI or an SSRI and the start of treatment with another drug. 5 weeks must pass between fluoxetine discontinuation and a new MAOI |
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How much time must pass after SSRI to MAOI
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At least 2 weeks should elapse between the discontinuation of treatment with either an MAOI or an SSRI and the start of treatment with the other drug. The exception is that 5 weeks must elapse between the discontinuation of fluoxetine and the administration of an MAOI.
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What is the effect of mood stabilizing drugs
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Normalize the swings of affect in bipolar disorder
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What is the standard drug used for mood stabilization
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Lithium
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What type of episode is lithium best at treating
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As with all the mood stabilizers the Greatest activity is against manic symptoms , less so against depression
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What is lithium used for
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Treat or prevent the manic phase of bipolar disorder
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Lithium pharmacokinetics
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Lithium is NOT metabolized.
Half life of about 24 hours and is excreted in the urine. Sodium can increase the excretion of lithium . |
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Lithium pharmacologic effects
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The maximal response to lithium often requires several days or weeks of treatment. For this reason, other drugs may need to be used during the early phase of treatment while awaiting the full response to lithium.
Serum concentration should be monitored |
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Lithium has a _____ margin of safety or therapeutic index
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Low
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What are signs of a lithium overdose ?
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Elevated levels can cause neurotoxicity and cardiac toxicity leading to arrhythmia. Nausea with vomiting can be one of the earliest signs
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Lithium S/A
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drowsiness, weight gain, a fine hand tremor, and polyuria
However it is well tolerated by most |
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What decreases lithium clearance ?
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NSAIDs and diuretics decrease clearance by about 25% and increase drug levels. Other drugs can increase potential neurotoxicity
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What increases lithium clearance due to competing space during renal tubular reabsorbtion
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Sodium
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Carbamazepine ( tegretol )
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A mood stabilizing drug
also an antiepileptic drug exhibits antimanic, antidepressant, and prophylactic effects equivalent to lithium, and it causes fewer adverse effects. Moreover, about 60% of manic patients who do not respond to lithium will respond to this drug within the first several days of treatment. |
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Valproate ( depakote )
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A mood stabilizing drug
Also an antiepileptic drug approved for mania in bipolar disorder. It appears to be especially useful in patients with rapid cycling of manic and depressive episodes and in patients with coexisting substance abuse |
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What is amphetamine
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the prototypical CNS stimulant, classified as an indirect-acting adrenergic agonist . It increases the release of norepinephrine and dopamine from nerve terminals.
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Adderall is a combination of what ?
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Amphetamine salts
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dextroamphetamine (DEXEDRINE)
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the active isomer of the racemic mixture of amphetamine
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methamphetamine (DESOXYN),
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CNS stimulant
high drug abuse , and easy manufacture |
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lisdexamfetamine (VYVANSE),
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CNS stimulant
a recently approved prodrug that is converted to dextroamphetamine after absorption |
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Methylphenidate (RITALIN)
Modafinil (PROVIGIL) Armodafinil (NUVIGIL) |
are also sympathomimetic agents and increase the levels of catecholamines in central and peripheral synapses like amphetamines but appear primarily to inhibit dopamine reuptake. These stimulants usually cause less irritability, anxiety, and anorexia than does amphetamine.
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Armodafinil is the active isomer of what drug ?
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Modafinil (PROVIGIL)
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Atomoxetine (STRATTERA)
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nonamphetamine drug that has some selectivity as a norepinephrine reuptake inhibitor
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Indications for stimulant treatment
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ADD
Narcolepsy Obesity |
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Methamphetamine indications
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indicated for short-term use in treating exogenous obesity. The newer agents, phentermine and sibutramine, are amphetamine derivatives used as appetite suppressants (anorectics)
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CNS stimulants all carry what risk
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risks of cardiovascular incidents, ranging from HTN to MI and sudden death.
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What are the major effects of CNS stimulants on young children
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Decreases in growth
Decreases in weight gain |
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All CNS stimulants are controlled substances with the exception of what drug.
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Atomoxetine (Strattera)
All other stimulants also have a high potential for abuse. Straterra is not actually considered a stimulant, but is indicated for ADD tx. It works by selective NE reuptake inhibition. |
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What is narcolepsy ?
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a sleep disorder characterized by excessive daytime sleepiness, even after sufficient nighttime sleep. Other symptoms include cataplexy, sleep paralysis, hypnagogic hallucinations, and automatic behavior; these are often triggered by sudden emotional reactions such as anger, surprise, or fear, and may last from seconds to minutes
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Clinical antipsychotic potency for typical antipsychotics correlate with actions at which receptor ?
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Dopamine D2
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Which agent is an antipsychotic that can improve both positive and negative sx of schizophrenia
Chlorpromazie Haloperidol Thiothixene Risperidone Thoridazine |
Risperidone is the only dual acting antipsychotic that works at both D2 and 5-HT2 receptors.
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Which of the following is not a class of antidepressant medications
Heterocyclic antidepressants TCA MAOI Acetylcholinesterase inhibitors SSRI |
Acetylcholinesterase Inhibitors
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The TCA share all the following adverse effects except which one ?
orthostatic hypotension sedation seizures weight gain sexual dysfunction |
Sexual dysfunction, that is seen in the SSRI primarily
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Foods containing tyramine should be avoided when taken with which class of medications?
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MAOI
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What is the mechanism of action of Benzodiazepines
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Potentiating the effect of GABA at chloride ion channels
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Benzodiazepines are noted for altering which one of the following aspects of sleep ?
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Decreasing the REM stage of sleep
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What is Flumazenil
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a selective benzodiazepine antagonist
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Zapelon differes from zolpidem in what way ?
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Has a shorter elimination half life
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What is an anxiolytic drug that is noted for its lack of sedation ?
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Busiprone
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