Term
| Tension, apprehension, unease |
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Definition
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Term
| Overreaction to unknown source or real stimulus |
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Definition
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Term
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Definition
| fear (tachycardia, sweating, trembling, palpations (SAS) |
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Term
| Types of Anxiety Disorders |
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Definition
generalized anxiety disorder
specific phobia
social phobia (stage fright)
panic d/o +/- agoraphobia
OCD
PTSD |
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Term
| first true antianxiety drug was.... |
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Definition
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Term
| second group of antianxiety was |
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Definition
barbiturates
more therapeutic but had a low TI |
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Term
| antianxiety group used more now |
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Definition
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Term
| Benzos, ethanol, and barbiturates all have... |
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Definition
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Term
| Benzos are inhibitory in nature via.. |
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Definition
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Term
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Definition
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Term
|
Definition
| iontropic receptor linked to Cl- channel |
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Term
GABA receptor
Cl- influx causes |
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Definition
| hyperpolarization and decreased neuronal firing |
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Term
| Actions of Benzos in low doses |
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Definition
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Term
| actions of benzos in high doses |
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Definition
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Term
| MANY (if not all) benzos are... |
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Definition
anterograde amnesia
(lose memory from the time you take the drug) |
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Term
|
Definition
anticonvulsant activity
muscle relaxation, relax spasticity (spinal?) |
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Term
|
Definition
autonomic side effects (do not block or stimulate PNS or SAS)
antipsychotic actions (do not help/prevent hallucinations)
analgesic actions |
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Term
|
Definition
oxazepam
triazolam
midazolam |
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Term
| famous for its amnestic effect, often used in short duration procedures where you dont want people to remember what is going on |
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Definition
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Term
| Intermediate acting benzos |
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Definition
alprazolam (xanax)
temazepam
lorazepam (ativan) |
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Term
|
Definition
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Term
| popular in the ER, also used as an anticonvulsant agent |
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Definition
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Term
|
Definition
diazepam (valium(
flurazepam
clonazepam
chloridazapoxide
Clorazepate |
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Term
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Definition
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Term
| ued exclusively as an anticonvulsant/antieptileptic |
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Definition
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Term
| Severe anxiety disorders, what is usually used |
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Definition
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Term
| What would be useful for infrequent events (ie a plane trip) |
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Definition
short acting benzo can be helpful
Triazolam
sometimes beta blockers
for refractory cases an SSRI can be given |
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Term
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Definition
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Term
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Definition
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Term
| drug for muscle relaxation |
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Definition
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Term
| drug for chronic epilepsy |
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Definition
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Term
| drug for grand-mal seizures (status epilepticus) |
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Definition
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Term
|
Definition
chlordiazepoxide
clorazepate
diazepam
lorazepam
oxazepam |
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Term
Sleep disorders
daytime sedation |
|
Definition
flurazepam (LA)
effective for 4 weeks
half-life = 85 hours (risk of OD) |
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Term
for frequent awakening
slow onset (2-3 hours) |
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Definition
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|
Term
for problems going to sleep
tolerance develops quickly (TAKE ONCE, NOT EVERY DAY) |
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Definition
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Term
|
Definition
decrease sleep induction time
decrease number of awakening
increase sleep duration |
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Term
| Rapid tolerance (days) especially... |
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Definition
SA
morning insomnia
daytime anxiety
amnesia/confusion |
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Term
|
Definition
rebound insomnia
use intermittently, use less than 2-4 weeks at a time |
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Term
| Pharmacokinetics of benzos |
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Definition
lipophilic w/ various half lives
metabolized in liver
metabolites excreted in urine |
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Term
| Confusion, anxiety, agitation, and insomnia |
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Definition
withdrawal symptoms
(SA worse) |
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Term
| Drowsiness, confusion, ataxia, and cognitive impairment |
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Definition
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Term
|
Definition
liver DZ
narrow angle glaucoma
W/ ETOH and other CNS depressants |
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Term
| Be aware of the potential for rebound anxiety when using.... |
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Definition
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|
Term
Benzo antagonist
used for rapid reversal of sedation and/or OD
IV only |
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Definition
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Term
Benzo withdrawal
(anxiety, seizures, sleep d/o, dizziness, N/V, agitation) |
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Definition
| adverse effects of flumazenil |
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Term
| Can be used in patients who have problems with dependence |
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Definition
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|
Term
stimualtes 5HT 1A receptors
also DA 2 and 5HT 2A
therefore differ from GABA agonists |
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Definition
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Term
minimal sedation, cognitive dyfunction
minimal dependence
no anticonvulsant
no muscle relaxant |
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Definition
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Term
| HA, dizziness, nervousness, slow onset of action |
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Definition
| Adverse effects of buspirone |
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Term
| antihistamine and antiemtic |
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Definition
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Term
Main action: sedation, common w/ antihistamines
little habituation
used when history of drug dependence |
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Definition
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Term
Antidepressants
First line when concerned about addition/dependence
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Definition
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Term
| less dependence and adverse effects, can cause withdrawal and be associated w/ the development of tolerance (except Rozarem) |
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Definition
other sedative/hypnotic agents
Lunesta, Sonata, Ambien, Chloral hydrate |
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Term
| Acts on subset of benzo site (BZ1) on GABA receptors |
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Definition
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Term
§ Effective up to 6 months compared to placebo |
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Definition
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Term
| Anxiety, dry mouth, chest pain, HA, migraine, edema, unpleasant taste |
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Definition
| adverse effects of lunesta |
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Term
Melatonin MT1 and MT2 receptor agonist
Associated w/ maintainence of circadian sleep rhythm promoting circuits in supraschiasmic nucleus |
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Definition
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Term
| HA, somnolence, fatigue, dizziness, nausea, insomnia, respiratory infection |
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Definition
| Adverse effects of Rozarem |
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Term
| Acts on subset of benzo site (BZ1) on GABA receptors (Me too drug) |
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Definition
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Term
§ Rapid onset and elimination (half-life = 1 hour), metabolized by CYP3A4 less “hangover” (???) |
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Definition
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Term
| Nightmares, agitation, HA, GI upset, dizziness, daytime drowsiness |
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Definition
| Adverse effects of sonata |
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Term
oral spray
acts on subset of benzo sites (BZ1) on GABA receptor
ME 2 of Sonata |
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Definition
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Term
| Replaced by benzos for sedation, induction, and maintainence of sleep |
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Definition
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Term
MOA : increase GABA action of Cl1 thru non-BZ sites
block gluatmate receptors and Na+ channels
decrease mesencephalic reticular activating system |
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Definition
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Term
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Definition
CNS depression: sedation, hypnosis, anesthesia
NO ANALGESIA (HYPER ANALGESIC)
respiratory depression, coma, death
induces CYP450 |
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Term
| Anesthesia barbiturate that has been replaced |
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Definition
| thiopental (Pentothal) IV |
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Term
| Anticonvulsant barbiturate that has been replaced |
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Definition
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Term
| Pharmacokinetics of barbiturates |
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Definition
IV: Brain > skeletal muscle > adipose
absorbed orally
metabolized in liver
excreted in urine |
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Term
Contraindicated in acute intermittent porphyria
(expose/exaggerate disease by inducing heme synthesis) |
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Definition
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Term
| Non-barbiturate sedatives |
|
Definition
cloral hydrates
antihistamines
ETOH
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Term
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Definition
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Term
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Definition
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Definition
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