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32 Cards in this Set
- Front
- Back
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Name two terms that may be used for drugs given to treat anxiety. What is an older term?
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Antianxiety agents or anxiolytics, older term = tranquilizers
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What is the term given to drugs that promote sleep?
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hypnotics
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Name the three major groups of sedative-hypnotics. How long has each group been in use?
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- Barbiturates – introduced in 1900s
- Benzodiazepines – 1950s - Benzodiazepine-like drugs – 1990s |
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Name the benzodiazepine that is probably most familiar to people. Give generic and brand name.
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Diazepam [Valium]
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What are the two most frequently prescribed benzodiazepines? Give generic and brand name.
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Lorazepam [Ativan] & alprazolam [Xanax]
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Name three therapeutic effects of benzodiazepines due to action on the central nervous system (CNS).
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Reduce anxiety, promote sleep & induce muscle relaxation
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How significant is the risk of respiratory depression with benzodiazepines? With oral therapy, when might clinically significant depression occur?
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- Weak respiratory depressants
- Oral – clinically significant respiratory depression occurs only when taken when combined w/ CNS depressants like opioids, barbiturates or alcohol |
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Define anterograde amnesia. What patient complaint may indicate the possibility of drug induced amnesia?
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- Impaired recall of events that take place after dosing
- forgetfullness |
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Name four possible symptoms of withdrawal after short term use with benzodiazepines
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Anxiety, insomnia, sweating, tremors & dizziness
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After long term use with benzodiazepines, what more serious reactions to withdrawal may occur?
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Panic, paranoia, delirium, HTN, muscle twitches, convulsions
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How can the intensity of withdrawal symptoms be minimized?
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Discontinuing treatment gradually
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What is the brand name of zolpidem?
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Ambien
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What are the two most common side effects of zolpidem? How frequent is their occurrence?
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Daytime drowsiness & dizziness, 1-2% of patients
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What is the recommended dose adjustment when zolpidem is given to elderly and debilitated patients
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5 mg
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What is melatonin?
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Hormone produced by the pineal gland
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What can be said about the melatonin levels in insomniacs?
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Low levels of melatonin
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What is the mechanism of action of ramelteon?
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Activates receptors for melatonin
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In what way does ramelteon promote sleep?
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Activation of MT1 receptors by endogenous melatonin induces sleepiness
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Name three advantages for the use of ramelteon.
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Absorption is rapid
Much of dose is concerted to an active metabolite |
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Name four side effects of ramelteon related to sexuality and reproduction which may result from increased levels of prolactin and decreased levels of testosterone?
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Amenorrhea, galactorrhea, reduced libido & fertility problems
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List 4 undesirable properties of barbiturates that have lead to the decreased use of these agents.
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Cause tolerance & dependence, high abuse potential, subject to multiple drug interactions, powerful respiratory depressant
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Name the short to intermediate acting barbiturate used to treat insomnia.
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Secobarital
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Identify at least three disadvantages to the use of chloral hydrate for insomnia.
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Tolerance develops quickly, needs high dose, subject to abuse, withdrawal can cause delirium & seizures
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Define insomnia and identify four different characteristics of poor sleep.
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Insomnia – inability to sleep well
Daytime drowsiness, impairment of mood, memory, coordination & ability to concentrate & make decisions |
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List three non-drug ways to treat insomnia
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Avoid naps, decrease consumption of caffeine, restful activity near bedtime
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To minimize drug-dependency insomnia, how should hypnotics be used?
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o Only when insomnia cannot be managed by other means
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What is the brand name for flurazepam?
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o Generic only, doesn’t have one
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Because flurazepam has a delayed onset and more prolonged duration, for what type of insomnia would it be a good choice?
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o Difficulty falling asleep & maintaining sleep
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Because flurazepam has a relatively long half life what is it likely to cause?
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o Likely to cause daytime drowsiness
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What are the brand names for…
1. Zolpidem 2. Eszopiclone |
1. Ambien or Ambien CR
2. Lunesta |
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What is the active ingredient in the over the counter medications, Nytol and Sominex? To what drug classification does it belong?
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Diphenhydramine
antihistamines |
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Look up diphenhydramine in your nursing drug guide. What is a common brand name that you are familiar with?
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Benadryl
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