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29 Cards in this Set

  • Front
  • Back

Area in middle of the brain for learning, memory and emotional expression.

Limbic System

Responsible for unconscious responses to extreme stress such as high BP, elevated respiratory rate, and dilated pupils.

hypothalamus

Network of neurons located in the entire length of the brainstem.




Stimulated = heightened alertness & arousal


Inhibited = drowsiness & sleep

Reticular Formation


  • Larger area where the Reticular Formation is located
  • Responsible for sleeping & wakefulness
  • Performs an alerting function for the entire cerebral cortex

Reticular Activating System (RAS)

used to Dx sleep d/o

EEG

Drugs that relieve anxiety

Anxiolytics

  • benzodiazepines
  • nonbenzodiazepines

Subclasses of Anxiolytics


  • Sedatives
  • Hypnotics
  • Sedative-Hypnotics
  • Tranquilizer

Depress the CNS

  • Cholinergics
  • Monoamines
  • Neuropeptides

Neurotransmitters of the CNS

Effects of CNS Depressants

Slows neuronal activity in the brain

sedates or relaxes a pt

sedatives

can induce sleep

hypnotics

sedatives at a higher dose that can induce sleep

sedative-hypnotics

an older term for drugs that produce a calm or tranquil feeling

tranqulizers

Tx of anxiety and/or depression by altering levels of NE and serotonin

antidepressants

Classifications of Antidepressants
  • Tricyclic Antidepressants (TCAs)
  • Monoamine Oxidase Inhibitors (MAOs)
  • Selective Serotonin Reuptake Inhibitor (SSRIs)
  • Atypical Antidepressants

SSRIs


-About
  • Well tolerated & considered a 1st line therapy.
  • Tx of mild to moderate depression.
  • Fewer anticholinergic effects than TCAs.


  • Decrease the reuptake of serotonin at selective nerve terminals in the CNS.
  • Weak effects on the reuptake of NE and dopamine.
  • Causing an increase of available serotonin which prolongs the stimulatory potential resulting in mood elevation & reduced anxiety.

Action of SSRIs

SSRIs


-Adverse Effects

Usually dissipates in 4-6 weeks.


agitation

Lexapro (Escitalopram)


-therapeutic and pharmacologic classes

Theraputic Class:



  • Antidepressant
  • Anxiolytic



Pharmacologic Class:



  • SSRI

Lexapro (Escitalopram)


-Clinical Applications
  • GAD
  • Depression



Off-Label Use: Panic d/o

Lexapro (Escitalopram)


-Administration
  • Do not use until at least 14 days have elapsed since d/c MAOIs
  • Dosing increments should be at least 1 week apart.
  • Reduce dose in older pts and pts with renal or hepatic impairments.

Lexapro (Escitalopram)


-Monitor for


  • increased levels of metoprolol in the plasma (a beta-blocker that affects the heart & circulation)
  • weight gain
  • sexual dysfunction (men & women)

Lexapro (Escitalopram)


-Adverse and/or Side Effects
  • dizziness
  • nausea
  • insomnia
  • somnolence (drowsy; ready to fall asleep)
  • confusion
  • seizures

Lexapro (Escitalopram)


-Contraindications/ Not recommended for pts with:
  • Pts who are breastfeeding.
  • Pts who have taken MAOIs in the last 14 days.
  • Alcohol should be avoided.

Lexapro (Escitalopram)


-Black Box Warnings!

increased risk of suicidal thinking

Lorazepam (ativan)

Sedative-hypnotic/anxiolytic/benzoAnxiety, mild sedative, epilepsyLong 1/2 life of 20 hrsAdverse:Drowsiness, sedation, amnesia, weakness Monitor: BP and respirations

Non benzo, non barbituate CNS depressant functions

Reduce Anxiety symptoms

Zolpidem (Ambien)

Sedative-hypnotic/nonbenzo/nonbarb CNS depressant Sleeping pillAdverse:Day sedation,confusion,amnesia,dizziness,depression,nausea,vomitingContraindicated in breastfeeding