Term
Four signs of inflammation: |
|
Definition
redness, pain, swelling, heat |
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Term
Immune response to foreign objects or to tissue damage results in: |
|
Definition
|
|
Term
Three common causes of inflammation are: |
|
Definition
asthma, trauma, arthritis |
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Term
|
Definition
|
|
Term
|
Definition
Pain, Fever, and Inflammation |
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|
Term
|
Definition
Medication used to alleviate pain |
|
|
Term
|
Definition
inflammation, fever, and pain |
|
|
Term
|
Definition
medication used to treat fever |
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|
Term
medications that can treat fever: |
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Definition
|
|
Term
What is the maximum daily dose of acetaminophen? |
|
Definition
|
|
Term
What are the risks of acetaminophen use: |
|
Definition
Liver toxicity and hypersensitivity |
|
|
Term
Why is acetaminophen overdose more common? |
|
Definition
Because multiple medications contain more than one ingredient, which often includes acetaminophen. |
|
|
Term
Name four common prescription only drugs that contain acetaminophen: |
|
Definition
Percocet, Lorcet, Tylenol #3, Ultracet |
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|
Term
NSAIDS are indicated for: |
|
Definition
|
|
Term
NSAIDS may be used with other pain medications if pain is... |
|
Definition
|
|
Term
|
Definition
Protects the gastrointestinal tract by creating protective prostaglandins and is produced in most tissues. |
|
|
Term
|
Definition
Produces the prostaglandins that contribute to pain and inflammation and is increased in response to inflammation or tissue damage. |
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Term
Where is COX-II normally produced? |
|
Definition
areas of inflammation or tissue damage, not normally produced in most tissues. |
|
|
Term
What process do NSAIDS interrupt to treat pain, inflammation? |
|
Definition
COX processes; stops the formation of prostaglandins that cause pain and inflammation |
|
|
Term
Name 2 common adverse reactions to NSAIDS that are not deemed "serious". |
|
Definition
Gastrointestinal nausea and heartburn, and Cardiovascular increase in blood pressure and fluid build up |
|
|
Term
Name 2 SERIOUS adverse reactions to NSAIDS. |
|
Definition
Bleeding and ulcers in the gastrointestinal tract due to GI irritation and decreased prostaglandins. Kidney Failure, especially if other kidney damaging medications are present. |
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|
Term
There are 6 situations listed where NSAIDS should be used with caution. What are these high risk groups? |
|
Definition
1: History of gastric/peptic ulcer or bleeding, 2: Hypertension 3: Renal Disease 4:Patients over 65 5:Congestive heart failure and 6: Cardiac diseases (blood clots, strokes, etc) |
|
|
Term
The three blackbox warnings for NSAIDS: |
|
Definition
Cardiovascular, Coronary Artery Bypass Graft Surgery, and Gastrointestinal |
|
|
Term
What are the black box cardiovascular warnings for NSAIDS? |
|
Definition
blood clots, stroke, heart attack |
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|
Term
What are the gastrointestinal blackbox warnings for NSAIDS? |
|
Definition
Bleeding, Ulceration, Perforation |
|
|
Term
Why is COX-II selectivity preferable? |
|
Definition
It avoids inhibition of GI tract prostaglandins |
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|
Term
There used to be 3 COX-II selective drugs on the market. Only celebrex remains. Why? |
|
Definition
Because of the increased risk in cardiovascular events! |
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|
Term
Ibuprofen, Naproxen, and Meloxicam all target which COX? |
|
Definition
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|
Term
Celecoxib targets which COX? |
|
Definition
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|
Term
Five major points for patients on NSAIDS: |
|
Definition
Take with food to decrease GI effects Tell RPh or MD whenever taking aspirin Do NOT exceed max dosage Do NOT take with alcohol (increase GI effects) Hypertension patients should monitor blood pressure closely while taking. |
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|
Term
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Definition
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|
Term
For a child with a fever greater than 102.5F, what is the dosing indicated for ibuprofen? |
|
Definition
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|
Term
For a child with a fever less than 102.5F, what is the dosing indicated for iburofen? |
|
Definition
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|
Term
What is an important point concerning ibuprofen dosing in children (max dose...)? |
|
Definition
Do not exceed 40mg/kg/day!! |
|
|
Term
What concentration of children's suspension is available in ibuprofen? |
|
Definition
|
|
Term
What concentration of Ibuprofen would you find in an infant suspension? |
|
Definition
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|
Term
What is indicated for acetaminophen dosing to treat children's fever? |
|
Definition
10 to 15mg/kg/dose q 4 to 6 h |
|
|
Term
What is the maximum daily acetaminophen dose for children? |
|
Definition
|
|
Term
What is the children's acetaminophen solution concentration OTC? |
|
Definition
|
|
Term
What is the infant formula for acetaminophen? |
|
Definition
|
|
Term
What classification is Aspirin? |
|
Definition
Anti-inflammatory analgesic and platelet inhibitor |
|
|
Term
What are the common uses for aspirin? |
|
Definition
Pain, Prevention or treatment of cardiac stent placement stroke or heart attack, and Fever |
|
|
Term
What is considered a low dose of aspirin? |
|
Definition
for cardiac purposes, 75 to 325mg daily |
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|
Term
What is a high dose of aspirin? |
|
Definition
Used for pain and fever, 325 to 1000mg q 4 to h |
|
|
Term
What are Aspirin precautions? |
|
Definition
DO NOT EXCEED 4grams per day! |
|
|
Term
3 common side effects of aspirin |
|
Definition
Bleeding (potentially serious) GI Ulceration Reye's Syndrome |
|
|
Term
What group of people should aspirin be avoided in? |
|
Definition
CHILDREN. Reye's Syndrome |
|
|
Term
|
Definition
Reye's (Ryes) syndrome is a rare but serious condition that causes swelling in the liver and brain. |
|
|
Term
Signs of Reye's Syndrome are.... |
|
Definition
confusion, seizures and loss of consciousness require emergency treatment. |
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|
Term
Is aspirin suggestible for children or teenagers with the flu or with chickenpox? |
|
Definition
NO, children and teenagers recovering from chickenpox or flu-like symptoms should NEVER take aspirin. |
|
|
Term
What risk factor increases the chance of developing Reye's syndrome in children, along with the use of aspirin to treat cough/cold or chickenpox? |
|
Definition
Having an underlying fatty acid oxidation disorder |
|
|
Term
|
Definition
Drug Enforcement Administration, which is a branch of the US government tasked with control of both legal and illegal substances that have abuse potential |
|
|
Term
How to pharmacists get access to medications that are controlled by DEA? |
|
Definition
Must register with the DEA and have special ordering processes, report when diversion is suspected, and have proper inventory |
|
|
Term
|
Definition
Any substance with abuse or addictive potential |
|
|
Term
|
Definition
Naturally derived opiates or synthesized substances with similar properties |
|
|
Term
|
Definition
have the highest potential for abuse and have no medicinal purposes |
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|
Term
Schedule 2 through 5 drugs... |
|
Definition
have therapeutic purposes, but still have some addictive properties |
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|
Term
Tramadol is used to treat what? |
|
Definition
|
|
Term
What is the drug class for tramadol? |
|
Definition
|
|
Term
What is the classification for tramadol? |
|
Definition
|
|
Term
What is the mechanism of action for tramadol? |
|
Definition
it is a weak opioid, and works on similar receptors to antidepressants, increasing availability of norepinephrine and seratonin |
|
|
Term
What are some drug interactions with tramadol? |
|
Definition
|
|
Term
What are some adverse effects of tramadol? |
|
Definition
flushing and itching (pruritis) CNS: dizziness, headache, drowsiness GI: Constipation, Nausea, Vomiting |
|
|
Term
What are 3 main counseling points for tramadol? |
|
Definition
use caution when doing activities that require alertness use caution if patients have opioid sensitivity or addiction issues may increase risk of seizures patients should watch the first few doses to see how tramadol effects them |
|
|
Term
What are some opioids used for moderate pain that are considered "stronger" than tramadol? |
|
Definition
Tylenol w/codeine, lortab, lorcet, norco, and vicodin |
|
|
Term
What are some of the schedule 2 opioids? |
|
Definition
Percocet/Endocet, Oxycontin, Roxicodone, Duragesic, MS Contin, Dilaudid |
|
|
Term
What are indications for schedule 2 opioids? |
|
Definition
severe pain, perioperative pain, sedation/anesthesia (fentanyl) |
|
|
Term
What are adverse effects of opioids? |
|
Definition
Sedation Constipation Nausea/vomiting Pruritis Euphoria Respiratory Depression |
|
|
Term
Which adverse effect of opioids may be serious? |
|
Definition
respiratory depression may require emergency attention if it becomes severe |
|
|
Term
What is a "true allergy" to morphine? |
|
Definition
|
|
Term
A patient is allergic to hydromorphone. What other 4 opioids should she avoid? |
|
Definition
morphine, codeine, oxycodone, and hydrocodone |
|
|
Term
If a patient is allergic to meperidine, what should they avoid as well? |
|
Definition
|
|
Term
a patient is allergic to an opioid, but wants to take methadone. Is this safe? |
|
Definition
yes, methadone does not cross react with any opioids. |
|
|
Term
If an opioid contains tylenol, is it short or long acting? |
|
Definition
|
|
Term
Is dilaudid long acting or short acting? |
|
Definition
|
|
Term
What are brand names of extended release tramadol? |
|
Definition
|
|
Term
What is Fentanyl's brand name? |
|
Definition
|
|
Term
What are short term opioids indicated for? |
|
Definition
short term, episodic, or breakthrough pain taken every 4 to 6 hours |
|
|
Term
What are uses for long term, er opioids? |
|
Definition
Chronic pain or short term in patients with persistent pain taken 1 to 3 times every day |
|
|
Term
Who should dose fentanyl? |
|
Definition
It can be very difficult to dose, and only should be dosed by experienced professionals such as pain management pharmacists or doctors. |
|
|
Term
What is a serious effect of morphine? |
|
Definition
It lowers blood pressure, especially if intravenously administered |
|
|
Term
A patient requires morphine, but there is concern about a drop in blood pressure. Should it be po or IV? |
|
Definition
|
|
Term
Who should dose fentanyl? |
|
Definition
It can be very difficult to dose, and only should be dosed by experienced professionals such as pain management pharmacists or doctors. |
|
|
Term
What is a serious effect of morphine? |
|
Definition
It lowers blood pressure, especially if intravenously administered |
|
|
Term
A patient requires morphine, but there is concern about a drop in blood pressure. Should it be po or IV? |
|
Definition
|
|
Term
There are 6 important counseling points for oral opioids. What are they? |
|
Definition
1. Cause drowsiness 2. avoid alcohol 3. may take with food to avoid upset stomach 4. will likely cause constipation (recommend increased water intake and could also recommend a stool softer with or without a laxative component) 5. May be habit forming 6. do not crush, cut, chew, masticate, etc, controlled release medications. |
|
|
Term
Fentanyl is available as a.... |
|
Definition
|
|
Term
How does Fentanyl get into the system? |
|
Definition
it is absorbed into the skin ad builds up in fat to be released slowly over time |
|
|
Term
Is fentanyl generalized or targeted for pain? |
|
Definition
it works systemically over entire body |
|
|
Term
What are 9 key points in counseling fentanyl patients? |
|
Definition
1. apply to a clean, dry, hair free area 2. apply immediately after removal from seal 3. fold upon itself and flush down toilet as soon as you take it off, this is the only case of flushing medication that is acceptable 4. wash hands after handling 5. do not apply heat to the batch, ie warm baths, heating blankets, etc, because absorption may be increased and could be toxic. 6. apply to upper torso 7. do NOT cut 8. each patch is 72 hours, then remove 9. takes 12 to 24 hours when first starting medication to absorb |
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|
Term
A patient mentions they are running a fever and they are picking up fentanyl. What is a point to be sure to mention to this patient? |
|
Definition
Fever can cause increased absorption of the patch's active ingredient which could be toxic. |
|
|
Term
What are the indications for Carisoprodol and Cyclobenzaprine |
|
Definition
Relief of muscle spasms or pain associated with acute musculoskeletal conditions |
|
|
Term
What is the indication for baclofen? |
|
Definition
Relief of spasticity related to central nervous diseases (muscular sclerosis, spinal cord injuries, etc) |
|
|
Term
For all muscle relaxers what are general adverse effects and counseling points? |
|
Definition
Somnolence, dizziness, gi upset (nausea and vomiting), increased effect duration in elderly patients, increased adverse effects in use with other CNS depressants (alcohol, opioids, etc) |
|
|
Term
What are some added adverse effects of Cyclobenzaprine? |
|
Definition
|
|
Term
What are some other risks of Carisoprodol? |
|
Definition
abuse or dependence with prolonged use greater than 2 weeks, and a risk of withdrawal if abruptly discontinued. |
|
|
Term
What is neuropathic pain? |
|
Definition
it is nerve pain resulting from damage |
|
|
Term
What may cause neuropathic pain? |
|
Definition
diabetes that is uncontrolled allows sugar in the bloodstream to cause physical damage to the nerves shingles causes nerve pain treatment only HELPS with symptoms, but is not reversable. |
|
|
Term
What are signs of uncontrolled diabetes? |
|
Definition
sensation of burning, prickling, or tingling numbness pain |
|
|
Term
What is the first line agent for neuropathic pain |
|
Definition
|
|
Term
What is the second line for neuropathic pain? |
|
Definition
lidocaine tramadol opioids some antidepressants |
|
|
Term
What are 2 commonly prescribed anticonvulsants for neuropathic pain? |
|
Definition
gabapentin and pregabalin |
|
|
Term
What are the indications for both pregabalin and gabapentin? |
|
Definition
neuropathic pain treatment, developed and approved for seizures fibromyalgia |
|
|
Term
What are common adverse effects of muscle relaxers? |
|
Definition
drowsiness (require titration) dizziness edema |
|
|
Term
What are serious adverse effects of muscle relaxers? |
|
Definition
increased suicidal thoughts (true for all seizure medications) |
|
|
Term
Topical Lidocaine is a... |
|
Definition
|
|
Term
How is lidocaine available? |
|
Definition
Lidoderm is the patch, topical gels creams oral solutions injectable |
|
|
Term
What are adverse effects of lidocaine? |
|
Definition
drowsiness bradychardia hypotension skin irritation |
|
|
Term
6 counseling points for lidoderm use? |
|
Definition
1. apply to clean, dry hair free area 2. do not apply to broken or damaged skin 3. apply immediately after removal from package 4. when taking off, fold on itself and flush 5. wash hands after handling 6. do not apply heat |
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|
Term
What are some other, specific to lidoderm counseling points? |
|
Definition
apply to painful area, but not to broken skin can apply up to 3 patches as prescribed patches may be cut, unlike fentanyl removal after 12 hours and left off for 12 hours reduces toxicity risk |
|
|
Term
What are the three types of headaches? |
|
Definition
tension headaches, migraines, cluster |
|
|
Term
Describe a tension headache? |
|
Definition
mild to moderate headache pain that is usually dull with bilateral tightness or pressure May be mildly sensitive to light and sound Can be episodic or chronic |
|
|
Term
What is best used for tension headaches? |
|
Definition
NSAIDS or APAP (may combine with caffeine) |
|
|
Term
What is typical of a migraine? |
|
Definition
Recurrent, severe headache that interferes with function may or may not have an aura |
|
|
Term
|
Definition
usually precedes a migraine by 10 to 30 minutes, and is typically visual (such as a blank spot in the vision or flashing lights) It may also be a sensory aura, with numbness up one arm or in the face. |
|
|
Term
What are some signs of migraines? |
|
Definition
frequently unilateral lasts between 4 hours and 3 days can be associated with nausea and vomiting, sensitivity to light sound or movement may be associated with menstruation improves with sleep |
|
|
Term
What is a cluster headache? |
|
Definition
attacks of several unilateral headache pains occurring in a series with periods of remission. |
|
|
Term
Symptoms of cluster headaches. |
|
Definition
most severe headache type usually last 2 weeks to 3 months each headache lasts 15 to 180 minutes pain occurs aroud eyes or temples remission periods average about 2 years |
|
|
Term
What type of medications are used to treat cluster headaches? |
|
Definition
"Triptans", AKA Serotonin Agonist |
|
|
Term
How are the Sumatriptan Serotonin Agonists available? |
|
Definition
as tablet, nasal spray, and injection |
|
|
Term
How is the nasal spray for Sumatriptan dosed? |
|
Definition
as a 5 to 20 mg spray 5mg spray once into 1 nostril for 10 mg dose, spray once into each nostril DO NOT BREATHE DEEPLY for 10 to 20 seconds after use each unit is only one dose. |
|
|
Term
What are common side effects of Sumatriptan? |
|
Definition
nausea/vomiting dizziness flushing |
|
|
Term
What are serious side effects of sumatriptan? |
|
Definition
hypertension stroke seizure |
|
|
Term
What are contraindications for sumatriptan? |
|
Definition
if you have had a previous heart attack or stroke, or have uncontrolled hypertension if you have severe liver impairment |
|
|
Term
With imitrex, what are listed as category X drug interactions (as in, DO NOT USE together)? |
|
Definition
Ergot derivatives which are also used for headaches MAOI's (monoamine oxidase inhibitors) |
|
|
Term
What is lexi-comp class D ranking? |
|
Definition
|
|
Term
What is lexi-comp class C ranking? |
|
Definition
|
|
Term
What is lexi-comp class B ranking? |
|
Definition
|
|
Term
What is lexi-comp class A ranking? |
|
Definition
|
|
Term
What gets someone classified as having Major Depressive Disorder? |
|
Definition
5 or more of the main symptoms lasting for greater than two weeks that are a change from previous functioning
one symptom must be depressed mood or loss of pleasure, with four accompanying symptoms |
|
|
Term
What are symptoms of depression? |
|
Definition
Depressed mood, loss of interest, change in weight/appetite, change in sleep, psychomotor agitation or retardation, fatigue, feelings of worthlessness/guilt, trouble with concentration, thoughts of death |
|
|
Term
What is generalized anxiety disorder? |
|
Definition
GAD - excessive worry most days for more than six months difficulty controlling worry daily functions impaired WITH---3 of the following: restlessness fatigue difficulty concentrating irritability muscle tension sleep disturbance |
|
|
Term
|
Definition
Excessive and unreasonable obsession or compulsion that consumes at least one hour or more per day and must interfere with occupational, social, or other important fuctioning |
|
|
Term
|
Definition
Thoughts or impulses that are intrusive or inappropriate |
|
|
Term
|
Definition
Behaviors or mental acts the patient performs based on irrational beliefs about their obsessions. |
|
|
Term
|
Definition
Exposure to a traumatic event that threatened death or serious illness to ones self or others The patient then re-experiences the event persistently They develop avoidance behaviors |
|
|
Term
What are four common symptoms of PTSD? |
|
Definition
Difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, exaggerated startle response |
|
|
Term
What are 3 neurotransmitters that are associated with depression? |
|
Definition
Low levels of: Serotonin Dopamine Norepinephrine |
|
|
Term
What is Serotonin involved in? |
|
Definition
mood, appetite, sensory perception |
|
|
Term
|
Definition
Acts as a neurotransmitter regulating normal brain processes |
|
|
Term
|
Definition
Produces feelings of pleasure when released by the brain's reward system |
|
|
Term
What happens when Acetylcholine action is blocked? |
|
Definition
Anticholinergic response: "Can't see, can't pee, can't spit, can't s***" |
|
|
Term
What happens in geriatric patients who block acetylcholine? |
|
Definition
anticholinergic effects cause sedation and confusion, as well as the other four normal effects. |
|
|
Term
What does SSRI stand for? |
|
Definition
Selective Serotonin Reuptake Inhibitor |
|
|
Term
What are the main SSRI's we need to know (5)? |
|
Definition
Fluoxetine Paroxetine Sertraline Citalopram Escitalopram |
|
|
Term
What are SSRI's indicated for? (7 disorders) |
|
Definition
Depression GAD OCD PTSD Eating Disorders Premenstrual Dysphoric Disorder Fibromyalgia |
|
|
Term
|
Definition
It is when the NT that is released into surround space attaches to the receptor on the nerve that produced it, rather than moving to a nearby nerve. |
|
|
Term
What is the theory behind SSRI action? |
|
Definition
If reuptake is blocked, then the levels of NT remain higher in the spaces between the nerves, and therefore messages are communicated more effectively |
|
|
Term
What are the five common adverse effects of SSRI? |
|
Definition
Insomnia OR Somnolence GI Upset Anorexia Decreased libido Weight gain |
|
|
Term
What are 2 serious side effects of SSRI? |
|
Definition
Serotonine Syndrome (black box) Exacerbation of mania |
|
|
Term
What is Serotonin Syndrome? |
|
Definition
More likely to occur in combination with other medications that increase serotonin levels Very rare condition This is when the brain has too much serotonin. |
|
|
Term
What are the symptoms of Serotonin Syndrome? |
|
Definition
Restlessness Confusion Tachycardia Diarrhea Muscle Rigidity Twitching Fever Seizures Loss of Consciousness Death |
|
|
Term
What is the most common Tricyclic Antidepressant prescribed? |
|
Definition
|
|
Term
What are the indications for Amitriptyline (a TCA) |
|
Definition
Depression Neuropathy Insomnia Migraines Anxiety & Panic |
|
|
Term
What are adverse side effects of amitriptyline that are common? |
|
Definition
Drowsiness Anticholinergic Orthostatic Hypotension Weight Gain |
|
|
Term
What IS Orthostatic Hypotension? |
|
Definition
a drop in blood pressure upon standing a sensation of dizziness of light headedness |
|
|
Term
What are serious side effects and warnings for patients on amitriptyline? |
|
Definition
Can cause heart conduction abnormalities. tachycardia arrythmia myocardial infarction strokes |
|
|
Term
|
Definition
Serotonin Norepinephrine Inhibitors |
|
|
Term
What are the 2 SNRIs we should know? |
|
Definition
|
|
Term
What are some indications for SNRI? |
|
Definition
Depression Anxiety Disorders Neuropathic Pain OCD Hot Flashes Fibromyalgia |
|
|
Term
What are some common adverse effects of SNRIs? |
|
Definition
headache weight loss diaphoresis |
|
|
Term
|
Definition
|
|
Term
What are some serious side effects of SNRIs? |
|
Definition
Serotonin Syndrome Hypertension |
|
|
Term
What does a noradrenergic antagonist do? |
|
Definition
increases norepinephrine and serotonin |
|
|
Term
What is the name of a noradrenergic antagonist drug? |
|
Definition
|
|
Term
What are indications for Mirtazapine? |
|
Definition
Depression Insomnia Appetite stimulation |
|
|
Term
Which drug is classified differently, depending on the source you use? |
|
Definition
|
|
Term
What are common side effects of mirtazapine? |
|
Definition
increased appetite weight gain dry mouth constipation |
|
|
Term
What major drug interaction should we know about with mirtazapine? |
|
Definition
|
|
Term
What are Mirtazapine Counseling & Clinical Pearls? |
|
Definition
avoid activities that require alertness take in the evening (or prior to sleep) The lower dosage causes more sedation, but antidepressant effects are increased as dosage increases |
|
|
Term
What drug is classified as a dopamine reuptake inhibitor? |
|
Definition
|
|
Term
What is Bupropion indicated for? |
|
Definition
depression smoking cessation |
|
|
Term
What are adverse side effects of bupropion? |
|
Definition
hypertension weight loss headache insomnia |
|
|
Term
What are serious side effects of bupropion? |
|
Definition
Seizures at higher doses (be sure to dose with caution) Increased risk of seizures if taken with other drugs having the same effect |
|
|
Term
What are bupropion counseling points? |
|
Definition
may need to take it in the morning to avoid insomnia affect comes as either q6h, SR,ER Do not crush or chew the SR and XL versions of the drug |
|
|
Term
General antidepressant warnings? |
|
Definition
Do not abruptly stop-you must taper down not effective without therapy and counseling avoid alcohol use caution with other serotonergic medications will take several weeks for dose to work Increased suicide ideation and suicide in children,teens, and young adults |
|
|
Term
What is the most psychiatric disorder? |
|
Definition
|
|
Term
When does anxiety disorder commonly develop? |
|
Definition
Before the age of 30 years |
|
|
Term
What group is anxiety disorder more commonly found in (think gender, etc)? |
|
Definition
Women; individuals with social issues, and individuals with family history of anxiety and/or depression |
|
|
Term
What are the four pharmaceutical categories used to treat anxiety? |
|
Definition
SSRI/SNRI TCA Benzodiazepines Non-benzodiazepine anxiolytics |
|
|
Term
What are the indications for benzodiapezines? |
|
Definition
Sleep Panic Anxiety Seizures Alcohol Withdrawal Tranquilizers |
|
|
Term
What are common side effects of Benzodiazepines? |
|
Definition
Sedation Drowsiness Memory Difficulties Fatigue Muscle Weakness |
|
|
Term
What is the benzodiazepine drug schedule? |
|
Definition
|
|
Term
What are symptoms of alcohol withdrawal? |
|
Definition
Common are agitation, anxiety, nervousness, mood swings, and shakiness. Serious are hallucinations, confusion, and seizures |
|
|
Term
What is a contraindication for benzodiazepines? |
|
Definition
Severe respiratory insufficiency |
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Term
What are warnings and precautions of benzodiazepines? |
|
Definition
Use caution in peds, elderly, and drug abusers Anterograde Amnesia Suicidal Ideation |
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Term
What are drug interactions? |
|
Definition
Alcohol and CNS depressants |
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|
Term
What are clinical pearls of benzodiazepines? |
|
Definition
these are for short term use they are potentially addictive always taper slowly and avoid abruptly stopping Withdrawal symptoms again |
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Term
What is a clinical pearl of elderly patients regarding benodiazepines? |
|
Definition
Lorazepam is preferred over other benzodiazepines. |
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|
Term
What is Buspar indicated for? |
|
Definition
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|
Term
What are common side effects of buspar? |
|
Definition
Dizziness, drowsiness, headache, nervousness, and nausea |
|
|
Term
What are drug interactions for Buspar? |
|
Definition
Alcohol and CNS Depressants |
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|
Term
What are warnings and precautions for Buspar? |
|
Definition
Restlessness syndrome Cognitive/Motor Impairment Concurrent Use with MAOI |
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|
Term
What are clinical pearls of Buspar? |
|
Definition
Less potential for abuse Slower onset (takes at least a week for changes) Not for PRN use Preferred in pregnant women over Benzos |
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|
Term
There are how many stages of the sleep cycle? |
|
Definition
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|
Term
What happens in stage 1 of the sleep cycle? |
|
Definition
This is the interim between consciousness and sleep |
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|
Term
What happens in stage 2 of the sleep cycle? |
|
Definition
The heart rate slows, and the brain does less complicated tasks |
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|
Term
What happens in stage 3 of the sleep cycle? |
|
Definition
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|
Term
What happens in stage 4 of the sleep cycle? |
|
Definition
Body temperature and blood pressure decreases |
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|
Term
What happens in stage 5 of the sleep cycle? |
|
Definition
Increase in REM, heart rate, breathing, blood pressure, and temperature. |
|
|
Term
|
Definition
The complaint of difficulty initiating or maintaining sleep or of non-restorative sleep (not feeling well-rested after sleep that is adequate in amount) for at least 1 month. |
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|
Term
What percentage of population suffers from insomnia? |
|
Definition
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|
Term
Which gender is more susceptible to insomnia? |
|
Definition
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|
Term
What are four main causes (lifestyle factors)? |
|
Definition
Stresses Poor Sleep Hygiene Major Life Changes |
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|
Term
What are psychiatric causes of insomnia? |
|
Definition
Depression Anxiety Psychosis |
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|
Term
What are disease states that can cause insomnia? |
|
Definition
COPD Asthma Sleep Apnea Cancer GERD |
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|
Term
What are substances that can cause insomnia? |
|
Definition
Nicotine Caffeine Illicit Drugs Alcohol |
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|
Term
What are good on-pharmacological treatment? |
|
Definition
Good Sleep Hygiene Avoid caffeine, exercising within 6 hours of bedtime, taking naps during the day, watching tv in bed Relaxation training Stimulus-control therapy Intensive Sleep Training |
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|
Term
What class of medications are used to treat insomnia? |
|
Definition
non-benzodiazepine sedatives Antihistamine (first-generation) Antidepressants (specifically trazodone) |
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|
Term
What are side effects of Ambien? |
|
Definition
Dizziness, Headache, Anxiety, Confusion |
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|
Term
What are side effects of Lunesta? |
|
Definition
Headache, Unpleasant Taste |
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|
Term
What are drug interactions for both Lunesta and Ambien? |
|
Definition
Alcohol and CNS depressants |
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|
Term
What are warnings and precautions for both Ambien and Lunesta? |
|
Definition
Cause CNS depression, abnormal thinking/behavior changes, sleep-related activities
Caution in drug abuse, elderly, and females |
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|
Term
What are clinical pearls of Zolpidem and Eszoplicone? |
|
Definition
They produce a more natural sleep Cause fewer disturbances in sleep stages Decrease the amount of time to fall asleep Avoid abrupt discontinuation habit-forming short-term use take at bedtime |
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|
Term
What is a first generation antihistamine used for sleep? |
|
Definition
Vistaril/Hydroxyzine pamoate: |
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|
Term
What are side effects of Hydroxyzine? |
|
Definition
Dizziness Drowsiness Fatigue headache Dry Mouth |
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|
Term
What are clinical pearls of Hydroxyzine pamoate? |
|
Definition
They are less effective than benzodiazepines They are associated with residual daytime sedation and anticholinergic effects Beware of use in elderly patients or individuals with a history of alcohol or sedative-hypnotic abuse |
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|
Term
What are side effects of Oleptro, Desyrel? |
|
Definition
headache dizziness fatigue dry mouth nausea blurred vision |
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|
Term
What are drug interactions |
|
Definition
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|
Term
What does Trazodone interact with? |
|
Definition
SSRI's, SNRI's, linezolid, amiodarone |
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|
Term
What are warnings or precautions for trazodone? |
|
Definition
Suicidal thoughts or behaviors in children, adolescents, and young adults from 18 to 24 |
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|
Term
What is a clinical pearl about trazodone? |
|
Definition
Using lower doses is recommended for sedative effects (between 25 and 200mg |
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