Term
This client is experiencing ___.
Apprehension
Worry, fear
Palpitations
SOB
Heartburn
Dry mouth
Excess Sweating |
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Definition
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Term
| Can we use barbiturates for anxiety? |
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Definition
| NO! TOTALLY INAPPROPRIATE |
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Term
| Name 5 Pharmacologic categories for anxiety. |
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Definition
1. Benzodiazepines
2. Antihistamines
3. Tricyclic Antidepressants
4. SSRI's
5. Herbal Meds |
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Term
| All benzo's end in ___ or ___. |
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Definition
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Term
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Definition
1. Alprazolam (Xanax)
2. Diazepam (Valium)
3. Lorazepam (Ativan)
4. Temazepam (Restoril) |
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Term
What is the MOA of benzos?
They bind to ___ receptors and produce a calming effect on the ___. |
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Definition
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Term
| Benzodiazepines are ___ depressants. |
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Definition
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Term
| Name 5 adverse effects of benzos. |
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Definition
1. Respiratory depression
2. Dizziness
3. Drowsy
4. Ataxia
5. Confusion |
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Term
Teaching for benzos:
Can not drink ___ or ___.
Potential for ____ |
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Definition
Alcohol or grapefruit juice
Dependence |
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Term
| Benzos are pregnancy category __. They ___ the effects of birth control pills. |
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Definition
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Term
Drug/Drug interactions with Benzodiazepines:
Can't take with ___, ___, ___. |
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Definition
| Opioids, hypnotics, sedatives |
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Term
Drug/Drug interactions with Benzodiazepines:
Increased sedation with: ___, ___, ___, ___. |
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Definition
Antabuse
Kava Kava
Melatonin
Valerian |
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Term
Drug/Drug interactions with Benzodiazepines:
Decreased effects with ___ and excess ___. |
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Definition
Valproic acid (Depakote)
Excess caffeine
*Think soft drinks (acid and caffeine!) |
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Term
| The antidote for Benzo OD is ___. It can bring back S/S of anxiety, though. |
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Definition
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Term
| True or False: If a client is experiencing respiratory depression while on Benzos, do we give them Romazicon? |
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Definition
| It depends on how severe the RR depression is, and if we could try other approaches 1st.? |
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Term
How do antihistamines help anxiety?
Depress the ___; ___-generation __ receptor antagonists. |
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Definition
Depress the CNS
1st generation H1 receptor antagonists |
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Term
Name 2 antihistamines.
These are given __-__ mg IV or __. |
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Definition
1. Diphenhydramine (Benadryl)
2. Hydroxyzine (Vistaril, Atarax)
25-50 mg IV or IM |
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Term
Antihistamines can cause paradoxical ___ stimulation, especially in the ___.
S/S of this? |
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Definition
CNS; elderly
Restlessness, agitation, pulling at clothes. Wiggling in bed, can’t be still, anxious
Urinary retention/frequency, RR change, increased bronchial secretions |
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Term
| Antihistamines can cause anticholinergic side effects. Name 4. |
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Definition
1. Dry mouth
2. Blurred vision
3. Constipation
4. Urinary retention |
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Term
| Who would benefit from using antihistamines? |
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Definition
Insomnia, anxiety, allergic reactions
*Suspected abusers |
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Term
| What is the safest class of anti-anxiety drug? |
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Definition
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Term
| Name 4 drugs for long-term anxiety treatment. (SSRI/SNRI's) |
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Definition
1. Paxil
2. Prozac
3. Zoloft
4. Lexapro |
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Term
| Name 4 side effects of SSRI/SNRI's |
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Definition
1. Weight gain
2. Sexual dysfunction
3. Seizures
4. Serotonin Syndrome (Fever, agitated, high BP) |
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Term
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Definition
Confusion
Restless
Tremors
Flaccidity |
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Term
Name 3 herbal/OTC meds for anxiety.
Which is tolerated best? |
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Definition
Melatonin
Valerian
Kava Kava
Valerian (Smells BAD!) |
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Term
| High doses of melatonin can cause 3 problems. |
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Definition
| HA, mental impairment, nightmares |
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Term
Kava Kava can induce a coma when used with ____.
It can cause ___ damage. (Yellow skin/nails) |
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Definition
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Term
| Insomnia agents should be used cautiously in ___, ___, severe ___, ___ impairment |
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Definition
| COPD, apnea, severe CHF, neuro impairment |
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Term
| What 2 insomnia agents are CNS depressants and are meant to be short-term (__-__days)? |
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Definition
Ambien and Lunesta
7-10 days
When I asked a SHORT Mexican man,"Como ESTA?" He QUICKly said "BIEN"
lunESTA and amBIEN are SHORT term and QUICK acting. |
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Term
Ambien and Lunesta have ___ onset.
What does this mean for pt care? |
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Definition
Rapid
Give right before bed |
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Term
| Name 4 side effects of Ambien and Lunesta. |
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Definition
Daytime sedation
Confusion
N/V
Depression |
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Term
Do not drink ___ with Ambien/Lunesta.
In the elderly it can cause ___ and ___.
It can also cause ___-term memory loss and sleep ____, etc. |
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Definition
Alcohol
Aggression and combativeness
Short-term; sleep-walking |
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Term
| What is the safest drug for insomnia? |
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Definition
Rozerem
Sleep in a bed of roses with Rozerem |
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Term
| Rozerem is safe for ___ term use and less likely to be ___ or cause irregular ___ in women. |
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Definition
Long-term
Abused
Menstruation |
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Term
| Why is it important for the nurse to know secondary causes of insomnia? |
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Definition
| You need to treat the underlying problem, hopefully with non-pharm approaches |
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Term
| What 4 things can cause secondary insomnia? |
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Definition
Drugs
Medical D/O
Poor sleep hygeine
Stressful situation |
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Term
| ___ can keep patients from reaching deep sleep. |
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Definition
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Term
What type of secondary insomnia does this refer to?
Amphetamines, cocaine, alcohol, tobacco
CORTICOSTEROIDS, sympathomimetics, caffiene, antidepressants |
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Definition
|
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Term
What type of secondary insomnia does this refer to?
Dementia, anxiety, epilepsy, Parkinson's, Tourette's, psychosis, migraines, asthma, pain, apnea, COPD, GERD, hyperthyroid |
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Definition
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Term
What type of secondary insomnia does this refer to?
Noisy, light, large meals, exercise before bed, partner snores/moves |
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Definition
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Term
What type of secondary insomnia does this refer to?
Marriage, divorce, deatch, disease, stressful job |
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Definition
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Term
| What phase of sleep concerns the actual "dreaming?" Patients are susceptible to be ____ during this phase. |
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Definition
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Term
| This disease skips sleeps stages and goes directly into __-__ minutes of deep sleep. It is managed with ___ drugs. |
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Definition
Narcolepsy
15-20 minutes
Stimulant (Amphetamines, Methylphenidate) |
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Term
| When is the only scenario of anxiety in which you would use drugs before non-pharm? |
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Definition
| When a patient is 'dangerous' or has 'scary' vital signs |
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Term
| What is the primary side effect to look for in Ativan? |
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Definition
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Term
| What is the primary side effect to watch for in Zolpidem (Ambien, Tovalt)? |
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Definition
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