Shared Flashcard Set

Details

(Rebecca)DUR
DUR
222
Pharmacology
Graduate
08/25/2013

Additional Pharmacology Flashcards

 


 

Cards

Term
Four signs of inflammation:
Definition
redness, pain, swelling, heat
Term
Immune response to foreign objects or to tissue damage results in:
Definition
inflammation
Term
Three common causes of inflammation are:
Definition
asthma, trauma, arthritis
Term
Inflammation causes:
Definition
Fever and Pain
Term
Trauma causes:
Definition
Pain, Fever, and Inflammation
Term
Analgesic:
Definition
Medication used to alleviate pain
Term
Painful Stimuli causes:
Definition
inflammation, fever, and pain
Term
Antipyretic
Definition
medication used to treat fever
Term
medications that can treat fever:
Definition
NSAIDS and APAP
Term
What is the maximum daily dose of acetaminophen?
Definition
4 Grams per day
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
Term
NSAIDS are indicated for:
Definition
Fever and Analgesia
Term
NSAIDS may be used with other pain medications if pain is...
Definition
moderate to severe
Term
What is COX-I?
Definition
Protects the gastrointestinal tract by creating protective prostaglandins and is produced in most tissues.
Term
What is COX-II?
Definition
Produces the prostaglandins that contribute to pain and inflammation and is increased in response to inflammation or tissue damage.
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.
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
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
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!
Term
Ibuprofen, Naproxen, and Meloxicam all target which COX?
Definition
COX-I and COX-II
Term
Celecoxib targets which COX?
Definition
COX-II
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.
Term
1 kG is how many lbs?
Definition
2.2lbs
Term
For a child with a fever greater than 102.5F, what is the dosing indicated for ibuprofen?
Definition
10mg/kg/dose q 6 to 8 h
Term
For a child with a fever less than 102.5F, what is the dosing indicated for iburofen?
Definition
5mg/kg/dose q 6 to 8 h
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
100mg/5mL
Term
What concentration of Ibuprofen would you find in an infant suspension?
Definition
40mg/mL
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
2.6 grams per day MAX
Term
What is the children's acetaminophen solution concentration OTC?
Definition
160mg/5mL
Term
What is the infant formula for acetaminophen?
Definition
80mg/0.8mL
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
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
What is Reye's Syndrome?
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.
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
What is the DEA?
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
Define "narcotic"?
Definition
Any substance with abuse or addictive potential
Term
Define "Opioid"
Definition
Naturally derived opiates or synthesized substances with similar properties
Term
Schedule 1 drugs...
Definition
have the highest potential for abuse and have no medicinal purposes
Term
Schedule 2 through 5 drugs...
Definition
have therapeutic purposes, but still have some addictive properties
Term
Tramadol is used to treat what?
Definition
moderate pain
Term
What is the drug class for tramadol?
Definition
opioid analgesic
Term
What is the classification for tramadol?
Definition
not scheduled
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
St. John's Wort, SSRI's
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
rash or anaphylaxis
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
Fentanyl
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
short acting
Term
Is dilaudid long acting or short acting?
Definition
short acting
Term
What are brand names of extended release tramadol?
Definition
Ultram ER and Ryzolt
Term
What is Fentanyl's brand name?
Definition
Duragesic
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
PO
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
PO
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
transdermal patch
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
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
dry mouth
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
anticonvulsants
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
local anesthetic
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
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
Describe a migraine aura
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
consider therapy change
Term
What is lexi-comp class C ranking?
Definition
monitor therapy
Term
What is lexi-comp class B ranking?
Definition
No action needed
Term
What is lexi-comp class A ranking?
Definition
no interaction known
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
What is OCD?
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
What is an obsession?
Definition
Thoughts or impulses that are intrusive or inappropriate
Term
What is a compulsion?
Definition
Behaviors or mental acts the patient performs based on irrational beliefs about their obsessions.
Term
What is PTSD?
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
What is Norepinephrine?
Definition
Acts as a neurotransmitter regulating normal brain processes
Term
What is Dopamine?
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
What is reuptake of NT?
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
Amitriptyline
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
SNRI Stands For
Definition
Serotonin Norepinephrine Inhibitors
Term
What are the 2 SNRIs we should know?
Definition
Duloxetine
Venlafaxine
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
What is diaphoresis?
Definition
sweating
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
Mirtazapine
Term
What are indications for Mirtazapine?
Definition
Depression
Insomnia
Appetite stimulation
Term
Which drug is classified differently, depending on the source you use?
Definition
Mirtazapine
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
Metoclopramide
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
Bupropion
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
Anxiety Disorder
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
C-IV
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
Term
What are warnings and precautions of benzodiazepines?
Definition
Use caution in peds, elderly, and drug abusers
Anterograde Amnesia
Suicidal Ideation
Term
What are drug interactions?
Definition
Alcohol and CNS depressants
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
Term
What is a clinical pearl of elderly patients regarding benodiazepines?
Definition
Lorazepam is preferred over other benzodiazepines.
Term
What is Buspar indicated for?
Definition
anxiety
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
Term
What are warnings and precautions for Buspar?
Definition
Restlessness syndrome
Cognitive/Motor Impairment
Concurrent Use with MAOI
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
Term
There are how many stages of the sleep cycle?
Definition
5
Term
What happens in stage 1 of the sleep cycle?
Definition
This is the interim between consciousness and sleep
Term
What happens in stage 2 of the sleep cycle?
Definition
The heart rate slows, and the brain does less complicated tasks
Term
What happens in stage 3 of the sleep cycle?
Definition
The body makes repair
Term
What happens in stage 4 of the sleep cycle?
Definition
Body temperature and blood pressure decreases
Term
What happens in stage 5 of the sleep cycle?
Definition
Increase in REM, heart rate, breathing, blood pressure, and temperature.
Term
Define Insomnia
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.
Term
What percentage of population suffers from insomnia?
Definition
30%
Term
Which gender is more susceptible to insomnia?
Definition
women
Term
What are four main causes (lifestyle factors)?
Definition
Stresses
Poor Sleep
Hygiene
Major Life Changes
Term
What are psychiatric causes of insomnia?
Definition
Depression
Anxiety
Psychosis
Term
What are disease states that can cause insomnia?
Definition
COPD
Asthma
Sleep Apnea
Cancer
GERD
Term
What are substances that can cause insomnia?
Definition
Nicotine
Caffeine
Illicit Drugs
Alcohol
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
Term
What class of medications are used to treat insomnia?
Definition
non-benzodiazepine sedatives
Antihistamine (first-generation)
Antidepressants (specifically trazodone)
Term
What are side effects of Ambien?
Definition
Dizziness, Headache, Anxiety, Confusion
Term
What are side effects of Lunesta?
Definition
Headache, Unpleasant Taste
Term
What are drug interactions for both Lunesta and Ambien?
Definition
Alcohol and CNS depressants
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
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
Term
What is a first generation antihistamine used for sleep?
Definition
Vistaril/Hydroxyzine pamoate:
Term
What are side effects of Hydroxyzine?
Definition
Dizziness
Drowsiness
Fatigue
headache
Dry Mouth
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
Term
What are side effects of Oleptro, Desyrel?
Definition
headache
dizziness
fatigue
dry mouth
nausea
blurred vision
Term
What are drug interactions
Definition
Term
What does Trazodone interact with?
Definition
SSRI's, SNRI's, linezolid, amiodarone
Term
What are warnings or precautions for trazodone?
Definition
Suicidal thoughts or behaviors in children, adolescents, and young adults from 18 to 24
Term
What is a clinical pearl about trazodone?
Definition
Using lower doses is recommended for sedative effects (between 25 and 200mg
Supporting users have an ad free experience!