Term
| Four signs of inflammation: |
|
Definition
| redness, pain, swelling, heat |
|
|
Term
| Immune response to foreign objects or to tissue damage results in: |
|
Definition
|
|
Term
| Three common causes of inflammation are: |
|
Definition
| asthma, trauma, arthritis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Pain, Fever, and Inflammation |
|
|
Term
|
Definition
| Medication used to alleviate pain |
|
|
Term
|
Definition
| inflammation, fever, and pain |
|
|
Term
|
Definition
| medication used to treat fever |
|
|
Term
| medications that can treat fever: |
|
Definition
|
|
Term
| What is the maximum daily dose of acetaminophen? |
|
Definition
|
|
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
|
|
Term
| NSAIDS may be used with other pain medications if pain is... |
|
Definition
|
|
Term
|
Definition
| Protects the gastrointestinal tract by creating protective prostaglandins and is produced in most tissues. |
|
|
Term
|
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
|
|
Term
| Celecoxib targets which COX? |
|
Definition
|
|
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
|
Definition
|
|
Term
| For a child with a fever greater than 102.5F, what is the dosing indicated for ibuprofen? |
|
Definition
|
|
Term
| For a child with a fever less than 102.5F, what is the dosing indicated for iburofen? |
|
Definition
|
|
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
|
|
Term
| What concentration of Ibuprofen would you find in an infant suspension? |
|
Definition
|
|
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
|
|
Term
| What is the children's acetaminophen solution concentration OTC? |
|
Definition
|
|
Term
| What is the infant formula for acetaminophen? |
|
Definition
|
|
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
|
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
|
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
|
Definition
| Any substance with abuse or addictive potential |
|
|
Term
|
Definition
| Naturally derived opiates or synthesized substances with similar properties |
|
|
Term
|
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
|
|
Term
| What is the drug class for tramadol? |
|
Definition
|
|
Term
| What is the classification for tramadol? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Term
| Is dilaudid long acting or short acting? |
|
Definition
|
|
Term
| What are brand names of extended release tramadol? |
|
Definition
|
|
Term
| What is Fentanyl's brand name? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
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
|
|
Term
| What is lexi-comp class C ranking? |
|
Definition
|
|
Term
| What is lexi-comp class B ranking? |
|
Definition
|
|
Term
| What is lexi-comp class A ranking? |
|
Definition
|
|
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
|
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
|
Definition
| Thoughts or impulses that are intrusive or inappropriate |
|
|
Term
|
Definition
| Behaviors or mental acts the patient performs based on irrational beliefs about their obsessions. |
|
|
Term
|
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
|
Definition
| Acts as a neurotransmitter regulating normal brain processes |
|
|
Term
|
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
|
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
|
|
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
|
Definition
| Serotonin Norepinephrine Inhibitors |
|
|
Term
| What are the 2 SNRIs we should know? |
|
Definition
|
|
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
|
Definition
|
|
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
|
|
Term
| What are indications for Mirtazapine? |
|
Definition
Depression
Insomnia
Appetite stimulation |
|
|
Term
| Which drug is classified differently, depending on the source you use? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
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
|
|
Term
| Which gender is more susceptible to insomnia? |
|
Definition
|
|
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 |
|
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