NSG 552- Psychopharm Quiz #2

First line treatment for anxiety disorders SSRI TCA vs. SSRI vs. Benzo- which has the highest anticholinergic effects? TCA Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:15 Full screen Brainpower Read More Activating antidepressants that can result in symptoms of anxiety, agitation, restlessness Venlafaxine Medical conditions that may precipitate anxiety DM, thyroid disease, seizure, COPD Mechanism of action Benzodiazepines Enhanced activity of GABA at GABA-A receptor Effects of benzodiazepines in the elderly population increased risk of fall and hip fractures Clinical concerns when prescribing benzodiazepines abuse and addiction Benzodiazepines recommended for patients with liver disorders, alcohol use disorders Lorazepam, oxazepam, temazepam When can benzodiazepines be administered in anxiety patients? initial weeks of SSRI/SNRI initiation to rapidly reduce anxiety Clinical manifestation of Benzodiazepine withdrawal Insomnia, anxiety, hand tremors, irritability, anorexia, N/V, HTN, diaphoresis, tachycardia, tonic-clonic seizures= life threatening T/F: Abrupt abstinence after chronic use can be life threatening True Given to reverse the effects in the case of benzodiazepine overdose Flumazenil Benefits of benzodiazepines compared to antidepressants easy to start, fast acting Known teratogenic effects of Benzodiazepines cleft palate Buspar- Mechanism of action partial agonist at 5HT-1A= lower serotonergic activity Should be considered for patients with comorbid substance use who have anxiety buspirone This beta blocker frequently used for patients with performance anxiety and akathisia is contraindicated in patient with asthma or COPD d/t the risk of bronchospasm propranolol Examples of medications used for sleep onset insomnia Eszopiclone, Zaleplon, Zolpidem, Triazolam, Temazepam, Ramelteon Examples of medications used for sleep maintenance insomnia Suvorexant, Eszopiclone, Zolpidem, Temazepam, Doxepin Recommended sleep aide for elderly population First: sleep hygiene, Second: trazodone, Short-term: Zolpidem Mechanism of action of Ramelteon Selective Melatonin (MT1 & MT2 agonist) T/F: Tolerance to sedating effects of sedative/hypnotics can develop rapidly. True