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33 Cards in this Set

  • Front
  • Back

What is the first line treatment for anxiety disorders?

SSRIs b/c they have less side effects and more rapid onset of actions

What med is reserved for treatment-resistant conditions due to risk of hypertensive crisis?

Monoamine oxidase inhibitors (MAOIs)

What are the 3 main indications for benzodiazepines (BZs) an antiolytics and hypnotics?

-seizure disorder
*they may also be used for alcohol withdrawl

What are the downsides of using BZs?

- associated w/impaired psychomotor function, sedation, decreased cognitive function and ataxia.
-may cause depression
- lead to tolerance
- may lead to dependency

When/how should BZs be used?

- Short term bases to treat anxiety
- High potency BZs considered only due to to side effects or alternatives are unacceptable
- If the pt is unwilling to wait 4-6wk delay response of other antidepressants

Which meds are used to treat panic disorders?


Which meds are used to treat Acute mania?


Which meds are used for short-term hypnotic to induce sleep?


Which meds are used to treat muscle spasms?


Which meds are used to treat seizure disorders?

IV valium

Which meds are used to treat sedative withdrawl syndromw ?


Which meds are used for preoperative anesthesia?

Midazolam (versed)

When is klonopin used?

Panic disorders
Acute mania
seizure disorders

When is Ativan used?

Panic disorders
Acute mania
seizure disorders

When is valium used?

Muscle spasms
Seizure disorders
sedative withdrawl syndrome

What is the mechanism of action for BZs?

Potentiates and intensify the action of GABA. GABA inhibits and/or reduces aggression, excitation and anxiety

Where are BZs metabolized?

In the liver; will need periodic liver studies.

What are the long acting BZs, what is their half life and what is a nursing consideration pertaining to their metabolism?

- Librium
- Transexene
- Valium
- Centrex
Half life is 4 days therefore that can be suddenly d/c WITHOUT causing withdrawl

What are the short acting BZs, what is their half life and what is nursing consideration pertaining to their metabolism?

- Serax
Rapid elimination therefore sudden d/c WILL cause withdrawl

What are the side effects of BZs?

2 most important
- Anterograde amnesia (unable to form new memories)

CNS side effects
-Psychomotor impairment, drowsiness
- Muscle weakness, ataxia, vertigo
- Older adults more susceptible to side effects
-Cognitive impairment, sedative effects
*Combined with other CNS depressants may cause resp depression
*NO alcohol; potentates sedation

What should you teach a pt about BZs?

-Do not increase dosage
- Causes reduced ability to work mechanical equipment
- Avoid caffeine and alcohol
- Avoid pregnancy & breast feeding
-Stopping usage after 3-4mo may cause withdrawl
- Take with food, avoid antacids (delays absorption)

What are some contraindications for BZs?

-Driving, being around machinery
- pregnancy
- substance abuse
- glaucoma
- alcohol or CNS depressant users

What is a non-BZ used to treat anxiety and the advantages and disadvantages?

Buspirone (BuSpar)
-does not cause sedation
- no abuse potential
- does not enhance CNS depression
- does not interact with other drugs except MAOIs and Haldol
-takes several weeks to become effective; cannot be used as a PRN

What are indications for BuSpar?

-Anxiety: general anxiety disorder (GAD) and/or anxiety accompanying depressive symptoms
- Augments response to antidepressants
- Treats OCD
Reduce aggression in pt w/brain damage

What are the adverse affects of BuSpar?

-dizziness, drowsiness, headache, excitability
- Nausea, dry mouth, diarrhea, constipation

What classification/drugs are used to treat ADHD?

Stimulants such as Methylphenidate (Ritalin, Concerta, Metadate-ER, Adderall, Dexadrine)

What are the contraindications for stimulants?

-motor tics
-severe depression
-use cautiously in pt w/seizure disorders (lowers threshold)

What are side effects of methylphenidate?

- insomnia (give last dose before 6pm)
-Anorexia (take with food or after eating)
- Nausea
- increased/decreased HR & BP
- Tachycardia
-Use cautiously with other meds

What are nursing considerations for pt on long-term methylphenidate?

-long term problem is growth/weight suppression
- children must swallow pill whole; don't chew
- Store with cautio; high street value
- Avoid caffeine, chocolate and excessive sugar

What are the cholinesterase inhibitors and the mechanism of action?

- Reminyl
- Exelon
Prevents break down of ACh causing a delay in cognitive/functional decline in elderly pt w/AZ

What phase of AZ will cholinesterase inhibitors work and for how long?

Only works in the mild/moderate phase (except Namenda) and improvements peaks at 3 months will slow return to previous functioning in 9-12 months

Which drug demonstrated effectiveness in pt with moderate to severe AZ?


What are some side effects of Namenda?

- pain
- constipation