PC707- Pharm Module 7 Exam with 100% Verified and Updated Solutions

PC707- Pharm Module 7 Exam with 100% Verified and Updated Solutions What are six classifications of anxiolytics? - answerSSRI SNRI Azapriones Benzodiazapine Beta Blocker Sedative Antihistamine Should benzodiazepines be prescribed for daily use for anxiety? Why or why not? - answerNo- long term benzo use can lead to dependence Benzos are intended for immediate relief from an acute anxiety attack or as an adjunct until a safer anxiolytic agent can take full effect (ex: SSRI) What could happen if benzodiazepines are abruptly stopped after chronic use? - answerSeizures/withdrawal, benzos should be tapered to discontinue. What other drug class must be avoided in the use of benzodiazepines? - answeralcohol or illicit drug use, CNS depressants Can you rate the onset of action of benzos with the likelihood of abuse or dependence? - answerBenzo: fastest onset of action, associated with highest potential for abuse. Are SSRI's a good choice for the relief of acute anxiety? - answerNo SSRI's can take up to 30 days to take full effect, may need to add adjunct therapy to help bridge the gap. Can you list two drug to drug interactions with Buspirone (Buspar)? - answerfloxetine (prozac) - CYP inhibitor carbamazepine (tegretol)- CYP inducer What is the abuse potential when using hydroxyzine (Vistaril) in the treatment of anxiety? - answerno abuse or addiction concerns ** can have anticholingeric side effects** Which patients should avoid the use of hydroxyzine (Vistaril)? - answerelderly or those that could have exacerbated anticholingeric effects How do Beta- Blockers work to reduce anxiety related to public speaking? - answerBlock beta 1 and beta 1 adrenergic stimulation in the heart (induced by epinephrine and norepinephrine), relieves the catecholamine-mediated autonomic symptoms (fight or flight) without sedation. Who should avoid Beta-Blockers? - answerindividuals with cardiac history or who are already taking a beta blocker Can you list drug-to-drug interactions associated with St. John's Wort? - answerSSRI triptans Benzodiazapine Contraceptives Some abx Digoxin What are two agents recommended in the treatment of chronic insomnia? - answerLunesta (eszopiclone) Rozerem (ramelteon) Discuss the required patient education that must be provided regarding sleep medications. - answer- Do not take unless you have 7-8 hours to sleep - Take on a empty stomach 30 minutes before bed - Longer half life (eszopiclone- Lunesta) is associated with next day impairment - sleep walking, sleep driving, sleep eating, sleep sex have been reported with zolpidem and other "z drugs" - Do not combine with other CNS depressants or alcohol Which anxiolytics are considered safe in pregnancy? - answerbuspirone- cat b, but avoid d/t limited data vistaril- cat c, approved for short term use with anxiety, insomnia, or exhaustion secondary to prodromal labor ambien- cat c, last resort for short term therapy lexapro?- cat c Which sleep medications are considered safe in pregnancy? - answerambien- short term, last resort vistaril- safe in pregnancy What sleep medicine should be avoided in pregnancy? - answermelatonin Antidepressant MOA: SSRI - answerblocks the reuptake of serotonin --> increased serotonin in the synapse = overall increase in serotonin Antidepressant MOA: SNRI - answerboost serotonin and norepinephrine by blocking reuptake Antidepressant MOA: TCA - answerblock reuptake of serotonin and norepinephrine, increasing concentration at CNS synapse Antidepressant MOA: MAOI - answerinhibits MAO at nerve terminal (enzyme that breaks down serotonin and norepinephrine) --> increase serotonin and norepinephrine available for release Antidepressant MOA: Buproprion - answerblock dopamine and norepinephrine reuptake --> boosts NE and dopamine concent