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pirotte Pharm
pharm of sleep and anxiety
66
Other
Not Applicable
09/08/2005

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Cards

Term
why are benzos used in treating anxiety?
Definition
get people "over the hump" until SSRI kicks in
Term
what are the most common benzos used with SSRIs to treat anxiety?
Definition
alpraz, clonaz, loraz
Term
action of buspirone?
Definition
5-HT1A receptor agonist, D2R agonist
Term
gen considerations for choosing a benzo as an adjunct for anxiety
Definition
rapidity of onset, duration, hl, metabolism
Term
what benzos are used as anticonvulsants?
Definition
clonaz, nitrazepam, diaz
Term
what benzos are used as anesthesia adjuncts?
Definition
diaz, midaz
Term
gen char of benzos used as anesthesia adjuncts?
Definition
highly lipophilic, rapid onset
Term
benzo used as a muscle relaxant?
Definition
diazepam
Term
benzos approved for use a sleep drugs
Definition
estaz, temaz, quaz, fluraz, triaz
Term
why should triaz be avoided if possible?
Definition
high abuse potential
Term
benzos less likely to have decreased met with age?
Definition
OLT - oxaz, loraz, temaz
Term
more severe sed-hyp withdrawl as it relates to dose
Definition
high
Term
more severe sed-hyp withdrawl as it relates to duration of use
Definition
long
Term
more severe sed-hyp withdrawl as it relates to potency
Definition
high
Term
more severe sed-hyp withdrawl as it relates to half-life
Definition
short
Term
more severe sed-hyp withdrawl as it relates to time of onset
Definition
short
Term
action of zolpidem (Ambien)
Definition
interacts w/ BZ1
Term
absorption of zolpidem?
Definition
rapid/complete from GI
Term
time to peak plasma conc for zolpidem?
Definition
1-2hr
Term
met of zolpidem?
Definition
liver
Term
SE of zolpidem?
Definition
n+v+d, HA, dizzy, hi dose: amnesia, rebound insomnia
Term
time to peak action for zaleplon
Definition
1hr from GI tract
Term
hep met of zaleplon?
Definition
I w/ not active mets
Term
met of zaleplon inhibited by?
Definition
cimetidine (Tagamet) H-2 blocker
Term
which has worse hangover, zolpidem, zaleplon?
Definition
zolpidem
Term
antagonist of z/z?
Definition
flumazenil
Term
does eszopiclone alter stages of sleep?
Definition
no
Term
peak plamsa conc of eszopiclone?
Definition
1-2hrs
Term
hl of eszopiclone?
Definition
6h
Term
eszopiclone eliminated more slowly in the elderly?
Definition
yes
Term
potentiating interacting drugs with eszopiclone (3)
Definition
itraconazole, clarithro, ritonovir (CYP3A4I)
Term
antagonizing interacting drug with eszopiclone?
Definition
rifampicin (CYP3A4 activator)
Term
action of mirtazapine
Definition
a2 antagonist, 5-HT 2A 2C 3 blocker, increases 5-HT at 5-HT1AR
Term
action of amitriptyline
Definition
TCA
Term
action of amitriptyline at H1/H2 R
Definition
antagonist
Term
action of amitriptyline at Musc, A1 R
Definition
blockade (weak)
Term
SE of amitriptyline
Definition
orthostatic hypotension, cardiotox, confusion
Term
H-1R antagonists used for treatment of insomnia
Definition
cyclobenzaprine, hydroxyzine, diphenhydramine
Term
action of Nefazodone
Definition
5-HT2AR antag, 5-HT reuptake inhibitor
Term
does Nefazadone interfere w/ sex?
Definition
negative
Term
brain regions involved in anxiety?
Definition
amyg, mesiotemporal structures, thalamus, orbital/medial prefrontal cortex, insula, hypothalamus, brainstem nuclei
Term
NTs involved in anxiety
Definition
NE, 5HT, GABA, Glu
Term
neuropeptides involved in anxiety
Definition
Subs-P, NP-Y, CRF
Term
rationale for use of benzos in anxiety (4)
Definition
high TI, low liver induction, slow elimination, flumazenil
Term
important beneficial characteristics of lorazepam for treatment of anxiety
Definition
short onset, long hl
Term
caution w/ lorazepam
Definition
preexisting CNS depress, hyptotension, narrow angle glaucoma, ren/hep impaired, MG, PD
Term
does buspirone produce an active metabolite?
Definition
yes, 1-PP
Term
contraindications of buspirone
Definition
hep/ren impairment
Term
use of setraline
Definition
panic, PTSD, OCD
Term
caution w/ sertraline
Definition
preexist seizure, MI, heart diseas, hep/ren
Term
use of fluoxetine
Definition
OCD
Term
caution w/ fluoxetine
Definition
hep, seizure hx
Term
use of paroxetine
Definition
panic, depression, social anx, OCD
Term
caution w/ fluoxetine
Definition
seizure hx, mania, ren/card
Term
use of fluvoxamine
Definition
OCD (inc peds)
Term
caution w/ fluvoxamine
Definition
hep/card, seizure hx, suicidial hx
Term
action of venlafaxine
Definition
SNRI
Term
use of venlafaxine
Definition
GAD
Term
caution w/ venlafaxine
Definition
hypertension, cards
Term
GAD rx
Definition
venlafaxine, paroxetine, busp, loraz, clonaz
Term
panic disorder rx
Definition
sertraline, loraz, alpraz, clonaz
Term
social anxiety rx
Definition
paroxetine
Term
PTSD rx
Definition
sertraline, other SSRIs
Term
OCD rx
Definition
SSRI
Term
adverse effects of B-blockers used to treat sit anx
Definition
lethargy, vivid dreams, hallucinations
Term
sx of serotonin syndrome
Definition
hypertherm, muscle rigidity, clonus, changes in cognition, changes in vitals
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