Pharm 2 week 2
Card Set Information
Pharm 2 week 2
Drugs for Anxiety Disorders ADHD Bipolar Depression Drugs to manage psychosis Insulin
Kinds of anxiety disorders (5)
Generalized Anxiety Disorder (GAD)
Social anxiety disorder (social phobia)
Benzodiazapines act as... (4)
What does GABA do?
body's natural valium
-induces skeletal muscle relaxation
-depresses CNS function
What causes a benzodiazapine to cause anti-anxiety effects rather than hypnotic?
Benzodiazapine protoptypes (3)?
Valium (not used as much anymore)--diazapam
Benefits of benzodiazapines?
safer than general CNS depressants
less potential for abuse
-less tolerance and physical dependence
fewer drug interactions
what drug-drug interaction is most important to watch for with benzodiazepines?
other CNS depressants
Why don't you give the antidote to benzodiazapines (Romazicon) to a patient with a history of seizures?
it can induce seizures
which route of benzodiazapines requires the closest monitoring of vital signs? Which should you watch most particularly?
watch for cardiac issues (bradycardia, cardiac arrest)
what should you watch for when combining benzodiazapines and opiates?
AE's of benzodiazapines
anterograde amnesia (not always considered adverse when used for surgery)
effects opposite to what it's supposed to do (increased anxiety, etc)
benzodiazapines have greater effect on cardiac and blood pressure when given by which route?
IV (rather than PO)
when are benzodiazapines used?
General anxiety disorder
-short-term management of anxiety
-stabilize sever anxiety
Social anxiety disorder
What is the typical long-term management strategy for GAD?
buspirone and antidepressants
What are the advantages of buspirone?
doesn't increase effects of CNS depressants
lower potential for abuse
disadvantages of buspirone
what do you do to manage them?
takes longer to achieve peak and steady state
: 1 week
: several weeks
benzodiazapines can be used to stabilize anxiety initially until buspirone kicks in
what can buspirone be used to treat?
General anxiety disorder
common AE's of buspirone
rapid heart rate/chest pains/heart palpitations
patient education for buspirone during intial phase of treatment
wait to operate machinery and activities requiring alertness and psychomotor coordination until CNS effects are known
What outcome goals should you have for treatment with buspirone?
increased sense of well-being
reduction in feelings of anxiety
how do MAO Inhibitors work?
inhibit monoamine oxidase, an enzyme that metabolizes neurotransmitters like NE, seratonin and dopamine. When those are more available to receptors, it alleviates depression.
What can MAOI's be used to treat?
depression (not first choice)
why are MAOI's so troublesome?
They interact with pretty much everything!
Many drugs and foods
what are some AE's of MOAI's?
what foods should be avoided when on MAOI's?
foods high in tyramine:
tofu (soy curd)
What drugs can be used to treat depression?
St. John's Wort
What does SSRI stand for? How's it work?
Selective Serotonin Reuptake Inhibitors
stop serotonin reuptake so it's more available in the brain
What's the prototype SSRI?
medical term for antianxiety
can't form new memories after event that caused amnesia
long-term memories are intact
good for surgery
which drug class can cause anterograde amnesia?
how is a drug selected for depression?
by safety, side effects, drug interactions, tolerability, preference and cost
all are equally effective
how soon do antidepressants work?
: 1-3 weeks
: 12 weeks
what's the major consideration when treating with antidepressants?
what should you monitor?
Black Box warning
Monitor for thoughts of suicide, worsening mood, changes in behavior (esp in people less than 25)
What syndrome is a potential AE of SSRIs?
S/S of seratonin syndrome?
mental and musculoskeletal
agitation, confusion, anxiety
Tricyclic antidepressants MOA
block reuptake of norepinephrine
(similar to antipsychotics)
also block acetylcholine and histamine
Effects of tricyclic antidepressants due to inhibition of reuptake of seratonin and NE
: confusion, agitation
: dry mouth, urine retention
: flushing, hyperthermia
MOA of Monoamine Neurotransmitters and Tyramine (MOA's)
convert monamine neurotransmitters and foods with tyramine into inactive substances so they can't break down norepinephrine and seratonin
If MOA's aren't working, how should you go about switching to another drug?
discontinue 2 weeks before starting on another antidepressant
what AE may occur if a patient is taking an MOA and eats foods rich in tyramine?