NURS 615 maryville exam 2 Maryville University of Saint Louis | Questions with 100% Verified Answers | Latest Update

NURS 615 maryville exam 2 Maryville University of Saint Louis | Questions
with 100% Verified Answers | Latest Update
Question: Drugs with CNS effects act of what receptors (neurotransmitters)
Answer:
GABA Acetylcholine Seratonin Dopamine Norepinephrine

Question: Anti- anxiety drugs, and sedative hypnotic drug classes
Answer:
Benzodiazapimes, atypical anxiolytics, sedative hypnotics, barbituates

Question: Benzodiazepine drugs
Answer:
All the "pams" plus librium Alprazolam (Xanax) Chlordiazepoxide (Librium) Clonazepam (Klonopin)
Diazepam (Valium) Lorazepam (Ativan) Oxazepam (Serax)

Question: Benzodiazepine like drugs
Answer:
Eszopiclone (Lunesta) Zolpidem (Ambien)

Question: Mechanism of action of benzodiazepine
Answer:
increases the action of GABA (an inhibitory neurotransmitter) thereby decreasing neuronal excitation.
Benzos bind to the benzodiazepine receptor. When GABA increases, it decreases neuronal
excitation=reduction in anxiety, muscle relaxation, and anticonvulsant. Metabolized in the liver- highly
lipid soluble & protein bound

Question: Adverse effects of benzodiazepines
Answer:
Major effects due to action as CNS depressant- sedation, cardiac and resp depressant, depression,
confusion, hypotention May also see paradoxical anxiety, agitation, and acute rage Psychological and
physical dependence

Question: Considerations with benzodiazepines
Answer:
Development of dependence- must taper off as it can cause physical and psychological withdrawal
symptoms Xanax and Ativan are more likely to develop dependence. Prescribe Clonazepam (Klonopin)
is less likely for dependence due to its long action. Benzos are for short-term treatment of anxiety

,Question: Atypical Anxiolytic
Answer:
Buspirone (Buspar)

Question: Benzodiazepines interact with
Answer:
MAOI's, SSRI's, etoh, antihistamines, pregnancy category D

Question: Buspirone (Buspar) MOA
Answer:
Buspirone (BuSpar) - approved for the treatment of GAD Full agonist at the pre-synaptic serotinin-1A
(5-HT 1a) receptor, also has action at dopamine receptors Short half-life, but slow onset of action
Metabolized by oxidation, excreted in urine

Question: Buspirone (Buspar) considerations
Answer:
Absorbed well orally Should be taken with food to decrease first-pass effect NOT to be used in
individuals with liver or renal disease Takes 1 to 2 weeks for onset of anxiolytic effects. Up to 6 weeks
for maximum effects.

Question: Buspirone (buspar) interacts with
Answer:
Anti psychotics such as haldol- compete for metabolism site.

Question: Buspirone (Buspar) side effects
Answer:
Nausea, dizziness, headache, lightheadedness, agitation, insomnia, dry moulth

Question: Buspirone is used in conjuction with
Answer:
SSRI's-augements the response in individuals with agitated or anxious depression

Question: Barbiturates
Answer:
Before benzos, barbiturates were the standard treatment for anxiety. the "bitals" Anxiolytic,
sedative-hypnotic, anticonvulsant. Phenobarbital Metharbital

Question: Barbiturates MOA

, Answer:
Bind to GABA receptors (at a different site than BZDs) and cause prolonged opening of the Cl channel
Metabolized by CYP 2C19 - induce their own metabolism; excreted in the urine

Question: considerations for barbiturates
Answer:
Severe CNS depression - especially when combined with ETOH Significant abuse potential- pt can
overdose

Question: Neurotransmitters involved in depression
Answer:
*Serotonin - influences anxiety, sexual behavior, appetite, aggression, pain, obsessions, emesis, learning,
psychosis, migraine, sleep, suicidal ideation *Norepinephrine - influences level of activity, alertness,
appetite, sleep patterns Dopamine - influences sleep, sexual behavior, level of anxiety and agitation,
feelings of euphoria, addictions

Question: Different classes of antidepressants
Answer:
tryciclic (TCA's), Monoamine oxidase inhibitors (MOI's), Selective Serotonin Reuptake Inhibitors
(SSRIs), Selective norepinephrine reuptake inhibitor (SNRI's)

Question: SSRI drugs
Answer:
Most of these drugs are also indicated for the treatment of Depression, GAD, SAD (social anxiety
disorder), and OCD Fluoxetine: prozac Paroxetine: Paxil Sertraline: zoloft Citalopram: celexa
Escitalopram: lexapro

Question: SSRI MOA
Answer:
Blocks the reuptake of serotonin, so there is more serotonin available. It is a selective reuptake inhibitor
because it has different effects on other neurotransmitters. Metabolized by the CYP450 system Majority
are eliminated through the urine

Question: SSRI side effects
Answer:
N/V, HA, light-headedness, dizziness, dry mouth, ↑sweating, weight ↑↓, exacer of anxiety, agitation,
↓libido, premature ejaculation, no orgasm potential for serotonin syndrome

Question: Serotonin Syndrome