Term
| v Name two terms that may be used for drugs given to treat anxiety. What is an older term? |
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Definition
| Antianxiety agents or anxiolyticstranquilizers |
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Term
v What is the term given to drugs that promote sleep? |
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Definition
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Term
| v Name the three major groups of sedative-hypnotics. How long has each group been in use? |
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Definition
| Barbiturates 1900’sBenzodiazepines 1950’sBenzodiazepine-like drugs 1990’s |
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Term
| v Name the benzodiazepine that is probably most familiar to people. Give generic and brand name. |
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Definition
| Generic : diazepam Brand name: Valium |
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Term
v What are the two most frequently prescribed benzodiazepines? Give generic and brand name.
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Definition
| Lorazepam (Ativan) and Alprazolam (Xanax, Niravam) |
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Term
| v Name three therapeutic effects of benzodiazepines due to action on the central nervous system (CNS). |
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Definition
| Reduce anxiety, promote sleep, induce muscle relaxation |
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Term
v How significant is the risk of respiratory depression with benzodiazepines? With oral therapy, when might clinically significant depression occur?
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Definition
They are weak respiratory depressants
With oral therapy, clinically significant respiratory depression occurs only when benzodiazepines are combined with other CNS depressants (eg. Opioids, barbiturates, alcohol)
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Term
| Name three principle indications for benzodiazepines. |
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Definition
| Anxiety, Insomnia, seizure disorder |
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Term
| v What are four CNS affects when benzodiazepines are taken in sleep-inducing doses? |
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Definition
| Drowsiness, lightheadedness, incoordination, and difficulty concentrating |
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Term
| v Define anterograde amnesia. What patient complaint may indicate the possibility of drug induced amnesia? |
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Definition
| Impaired recall of events that take place after dosingForgetfulness |
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Term
| v Name four possible symptoms of withdrawal after short term use with benzodiazepines |
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Definition
| Anxiety, insomnia, sweating, termors, and dizziness |
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Term
v After long term use with benzodiazepines, what more serious reactions to withdrawal may occur?
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Definition
| Panic, paranoia, delirium, hypertension, muscle twitches, out right convulsions |
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Term
| v How can the intensity of withdrawal symptoms be minimized? |
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Definition
| By discontinuing treatment gradually |
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Term
v While similar in mechanism of action to benzodiazepines, what is the only indication for benzodiazepine-like drugs? In contrast to benzodiazepines, what three other therapeutic actions does zolpidem not share? |
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Definition
Zolpidem does not significantly reduce time in rapid-eye-movement (REM0 sleep and causes little or no rebound insomnia when therapy is discontinued In contrast to the benzodiazepines, zolpidem lacks anxiolytic, muscle relaxant, and anticonvulsant actions
like benzodiazepines, zolpidem can reduce sleep latency and awakenings and can prolong sleep duration.
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Term
| v What is the brand name of zolpidem? |
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Definition
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Term
v What are the two most common side effects of zolpidem? How frequent is their occurrence?
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Definition
| Daytime drowsiness and dizziness |
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Term
| v What is the recommended dose adjustment when zolpidem is given to elderly and debilitated patients? |
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Definition
| 6.25 my for elderly or debilitated patients (usual dose is 12.50 mg) |
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Term
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Definition
| A horomone produced by the pineal gland, which is located at the base of the brain |
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Term
| v What can be said about the melatonin levels in insomniacs? |
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Definition
| Melatonin levels are low in insomniacs |
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Term
| v What is the mechanism of action of ramelteon? |
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Definition
| Activation of receptors for melatonin |
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Term
| v In what way does ramelteon promote sleep? |
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Definition
| It has a rapid onset (about 30 minutes) and short duration, and hence is good for inducing sleep but not for maintaining sleep |
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Term
| v Name three advantages for the use of ramelteon. |
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Definition
| good to induce sleep, non addictive and not considered a controlled substance |
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Term
v Name four side effects of ramelteon related to sexuality and reproduction which may result from increased levels of prolactin and decreased levels of testosterone?
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Definition
Amenorrhea, galactorrhea, reduced libido, and fertility problems
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Term
| v List 4 undesirable properties of barbiturates that have lead to the decreased use of these agents.
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Definition
| Tolerance and dependence, have a high abuse potential, and are subject to multiple drug interaction They are powerful respiratory depressants that can be fatal in overdose |
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Term
| Name the short to intermediate acting barbiturate used to treat insomnia. |
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Definition
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Term
| v Identify at least three disadvantages to the use of chloral hydrate for insomnia. |
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Definition
It’s subject to abuse and is classified as a schedule IV drug Prolonged consumption results in substantial tolerance and physical dependence Abrupt withdraw can cause delirium and seizures Can be fatal if un treated |
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Term
| v Define insomnia and identify four different characteristics of poor sleep. |
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Definition
| Insomnia can be defined as the inability to sleep well Difficulty falling asleep Difficulty maintaining sleep Troubled by early morning awakening Sleep that is not refreshing |
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Term
| List three non-drug ways to treat insomnia |
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Definition
| Avoid taking napsAdherence to a regular sleep scheduleDecrease caffeineRestful activity as bedtime nears |
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Term
| v To minimize drug-dependency insomnia, how should hypnotics be used? |
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Definition
| Hypnotics should be used only when insomnia cannot be managed by other means. Hence, before resorting to drugs, we should employ non drug measures, and we should treat any |
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Term
| What is the brand name for flurazepam? |
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Definition
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Term
| v Because flurazepam has a delayed onset and more prolonged duration, for what type of insomnia would it be a good choice? |
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Definition
| For patients who have difficulty maintaining sleep |
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Term
| v Because flurazepam has a relatively long half life what is it likely to cause? |
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Definition
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Term
What are the brand names for… o Zolpidem -
o Eszopiclone- |
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Definition
o Zolpidem - Ambien
o Eszopiclone- Lunesta |
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Term
| v What is the active ingredient in the over the counter medications, Nytol and Sominex? To what drug classification does it belong? |
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Definition
| the drug class is allergy, antihistamines, and antititussive |
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Term
| v Look up diphenhydramine in your nursing drug guide. What is a common brand name that you are familiar with? |
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Definition
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