1
Q
A patient receiving IV lorazepam becomes increasingly drowsy, with a respiratory rate of 8/min. What is your PRIORITY nursing action?
A
Stop the medication, maintain airway, support breathing, and notify the provider immediately.
2
Q
A patient with acute alcohol withdrawal is shaking and agitated. Why is lorazepam an appropriate medication for this situation?
A
It enhances GABA, calming CNS hyperactivity caused by withdrawal and preventing seizures.
3
Q
Your patient is scheduled for lorazepam before a procedure. What assessment must you perform FIRST?
A
Baseline vital signs—especially respiratory rate, blood pressure, and LOC.
4
Q
A client takes lorazepam nightly for insomnia. They ask to continue it long-term. How do you respond therapeutically?
A
Explain that lorazepam is only for short-term use due to the risk of dependence and tolerance.
5
Q
Which patient is the MOST at risk for complications from lorazepam? A) A 25-year-old with acute anxiety B) A 40-year-old with insomnia C) A 78-year-old with COPD D) A 28-year-old post-operative patient
A
C — A 78-year-old with COPD
6
Q
Your patient given IV lorazepam for a seizure is now confused and difficult to arouse. What should you check immediately?
A
Their respiratory rate, oxygen saturation, and level of consciousness.
7
Q
Why is lorazepam preferred over diazepam during a seizure?
A
Lorazepam has a longer duration of action in the CNS despite a shorter half-life and provides more sustained seizure control.
8
Q
A patient receiving lorazepam says, “I feel less anxious already.” What is the best indicator that the medication is working therapeutically?
A
The patient has decreased anxiety, calmer behaviour, and improved ability to participate in care.
9
Q
A patient receiving lorazepam becomes hypotensive. What is the best nursing intervention?
A
Lay the patient flat, reassess vitals, ensure safety, and notify the provider.
10
Q
Why is lorazepam not preferred IM unless absolutely necessary?
A
IM absorption is unpredictable, delayed, and may cause irritation.
11
Q
A patient on lorazepam asks if they can drink alcohol with it. What do you tell them?
A
“No — combining alcohol with lorazepam can dangerously increase sedation and depress breathing.”
12
Q
After giving lorazepam, how can you prevent patient injury?
A
Implement fall precautions: bed low, call bell within reach, side rails, and supervision when ambulating.
13
Q
A patient received lorazepam and morphine within the same hour. Which assessment finding requires IMMEDIATE intervention?
A
Respiratory rate of 8/min.
14
Q
A patient on a benzodiazepine becomes difficult to arouse. What is your FIRST action?
A
Assess airway, breathing, and respiratory rate.
15
Q
A client drinks alcohol while taking their prescribed lorazepam. Why is this dangerous?
A
Both depress the CNS, further slowing breathing and consciousness, increasing risk of overdose.
16
Q
A patient receiving a CNS depressant has BP 82/50 and HR 58. What physiological process caused this?
A
Depressants slow the autonomic nervous system → decreased heart rate and blood pressure.
17
Q
A patient given IV lorazepam shows snoring respirations and cannot stay awake. What complication is developing?
A
CNS depression leading to respiratory depression.
18
Q
Why is giving two CNS depressants together (e.g., lorazepam + opioid) high risk even at normal doses?
A
Their effects are additive, increasing the chance of slowed breathing, hypotension, and unconsciousness.
19
Q
A patient with COPD is prescribed lorazepam for anxiety. Why must the nurse question this order?
A
COPD patients rely on respiratory drive; CNS depressants can dangerously suppress their breathing.
20
Q
A client who has been drinking alcohol takes an extra opioid for pain. What is the priority teaching point?
A
“Alcohol + opioids can stop your breathing — never take them together.”
21
Q
What nursing intervention reduces injury risk after giving a CNS depressant?
A
Implement fall precautions (bed low, call light, supervision).
22
Q
A patient on CNS depressants becomes hypotensive. Why does this happen?
A
Depressants reduce sympathetic nervous system activity → vasodilation → low blood pressure.
23
Q
A patient is given a bedtime dose of lorazepam and appears very relaxed. How do you know it is working therapeutically?
A
The patient reports reduced anxiety and improved ability to sleep.
24
Q
What is the most important safety assessment when giving ANY CNS depressant?
A
Respiratory rate and depth.
25
A patient reports chronic sleep deprivation and now presents with hypertension. How can lack of sleep contribute to cardiovascular disease?
Sleep deprivation increases stress hormones and sympathetic activity → raising BP and inflammation → increasing risk for hypertension, heart disease, and stroke.
26
A client has been getting only 3–4 hours of sleep per night and frequently gets sick. What physiological process explains this?
Poor sleep weakens immune function, reducing the body’s ability to fight infections.
27
A nursing student complains of poor memory and trouble concentrating after multiple nights of limited sleep. Which effect of sleep deprivation is occurring?
Impaired cognitive function and performance due to insufficient brain rest and memory processing.
28
Why might a patient with chronic sleep loss experience depression or social withdrawal?
Sleep deprivation disrupts emotional regulation and increases fatigue → leading to mood changes, irritability, and reduced social engagement.
29
A pediatric patient shows delayed growth and is found to have low growth hormone levels. How does sleep deprivation explain this?
Growth hormone is primarily released during deep sleep; lack of sleep → decreased secretion → impaired growth.
30
The nurse recognizes that a patient with chronic insomnia is at higher risk for long-term illness. Which categories of illness are associated with poor sleep?
Chronic illnesses such as cardiovascular disease, metabolic disorders, depression, and impaired immune conditions.
31
A client experiencing prolonged sleep loss reports always feeling cold. What mechanism explains this?
Sleep deprivation disrupts thermoregulation → reduced body temperature.
32
A shift worker getting insufficient sleep has increased errors at work. What sleep-related change explains this?
Decreased cognitive function and alertness → decreased performance and slower reaction times.
33
A patient states, “I only sleep 4 hours a night but feel fine.” What should the nurse emphasize regarding long-term risks?
Even if the patient feels okay short term, chronic sleep deprivation increases mortality risk and long-term health consequences.
34
A patient receives a low dose of lorazepam and reports feeling calmer but not sleepy. Which effect is this?
Sedative effect — calming the CNS without causing sleep.
35
The same patient receives a higher dose of lorazepam later and falls asleep quickly. Why did the drug act differently?
Because **dose determines the effect** — higher doses produce hypnotic (sleep-inducing) effects.
36
A nurse wants to reduce a patient’s anxiety without sedating them for sleep. Which class is most appropriate?
Benzodiazepines at **sedative** doses.
37
Which group of sedative-hypnotics has the **highest risk** for severe CNS depression and overdose?
Barbiturates.
38
A patient is given a hypnotic before surgery. What is the expected effect?
To induce sleep and reduce consciousness.
39
Why must sedative-hypnotic medications be used cautiously with opioids or alcohol?
Their CNS depressant effects can combine → causing respiratory depression or loss of consciousness.
40
A patient is on a “non-benzodiazepine sedative” like zolpidem (Ambien). How does its purpose differ from benzodiazepines?
Non-benzodiazepines are specifically designed to **promote sleep** with fewer side effects like daytime drowsiness.
41
In what situation would a sedative dose be preferred over a hypnotic dose?
When you want to reduce anxiety (e.g., before a procedure) without inducing sleep.
42
The nurse notes that the patient becomes overly sedated at normal doses of a hypnotic. What factor might be affecting this response?
Age (older adults), liver dysfunction, or interactions with other CNS depressants.
43
A provider orders a barbiturate for sleep. What must the nurse consider first?
Barbiturates can cause profound CNS depression → high risk of overdose, dependence, and respiratory failure.
44
A patient asks, “Why can one medication help anxiety but also help me sleep?”
Explain: “It depends on the dose — at lower doses it calms you (sedative), at higher doses it induces sleep (hypnotic).”
45
Which category of sedative-hypnotics is safest for short-term anxiety or sleep problems?
Benzodiazepines (short-term only).
46
Why is diazepam preferred over a short-acting benzodiazepine for alcohol withdrawal?
Long-acting benzos provide **more stable, prolonged withdrawal control**, reducing the risk of seizures.
47
A patient needs something for anxiety but wants to avoid next-day grogginess. Which category is best?
Intermediate-acting benzodiazepines (e.g., lorazepam) — balanced effect, less daytime sedation.
48
Why is lorazepam commonly used for pre-procedure sedation?
It reduces anxiety, provides amnesia, and has a predictable intermediate duration.
49
A patient taking alprazolam (Xanax®) stops abruptly and becomes shaky and anxious. Why?
Short-acting benzos clear quickly → high risk for rebound symptoms and withdrawal.
50
Short-Acting: Best Indication
Which benzodiazepine is most appropriate for someone who has trouble *falling asleep*, not staying asleep?
A short-acting agent (e.g., triazolam).
51
Sedation Depth
Which category would be used during a minor procedure like endoscopy?
**Short-acting** (midazolam) for rapid onset and quick recovery.
52
Choosing Safely for Older Adults
Which benzodiazepine duration is safest for older adults?
Intermediate or short-acting (avoid long-acting due to accumulation and fall risk).
53
Panic Attacks
A patient experiences sudden panic attacks. Which category works fastest for relief?
Short-acting (e.g., alprazolam), because they have rapid onset.
54
Drug Accumulation
A patient taking flurazepam for sleep reports being groggy all day. What’s happening?
Drug accumulation due to long half-life → next-day sedation.
55
Liver Impairment
Which benzodiazepine class should be avoided in liver dysfunction?
Long-acting (e.g., diazepam), because they rely on liver metabolism and have active metabolites.
56
Withdrawal Planning
A provider wants to taper someone off benzodiazepines safely. Which category may be used to stabilize the taper
Long-acting (e.g., diazepam) because they leave the body slowly and prevent withdrawal spikes.
57
An older adult is prescribed diazepam for muscle spasms. What major risk should the nurse monitor for?
Daytime sedation and increased fall risk due to long half-life and drug accumulation.
58
Why is diazepam preferred over a short-acting benzodiazepine for alcohol withdrawal?
Long-acting benzos provide more stable, prolonged withdrawal control, reducing the risk of seizures.
59
A patient needs something for anxiety but wants to avoid next-day grogginess. Which category is best?
Intermediate-acting benzodiazepines (e.g., lorazepam) — balanced effect, less daytime sedation.
60
Why is lorazepam commonly used for pre-procedure sedation?
It reduces anxiety, provides amnesia, and has a predictable intermediate duration.
61
A patient taking alprazolam (Xanax®) stops abruptly and becomes shaky and anxious. Why?
Short-acting benzos clear quickly → high risk for rebound symptoms and withdrawal.
62
Which benzodiazepine is most appropriate for someone who has trouble falling asleep, not staying asleep?
A short-acting agent (e.g., triazolam).
63
Which category would be used during a minor procedure like endoscopy?
Short-acting (midazolam) for rapid onset and quick recovery.
64
Which benzodiazepine duration is safest for older adults?
Intermediate or short-acting (avoid long-acting due to accumulation and fall risk).
65
A patient experiences sudden panic attacks. Which category works fastest for relief?
Short-acting (e.g., alprazolam), because they have rapid onset.
66
A patient taking flurazepam for sleep reports being groggy all day. What’s happening?
Drug accumulation due to long half-life → next-day sedation.
67
Which benzodiazepine class should be avoided in liver dysfunction?
Long-acting (e.g., diazepam), because they rely on liver metabolism and have active metabolites.
68
A provider wants to taper someone off benzodiazepines safely. Which category may be used to stabilize the taper?
Long-acting (e.g., diazepam) because they leave the body slowly and prevent withdrawal spikes.
69
What is the main purpose of benzodiazepines?
To calm the central nervous system (CNS) and reduce overactivity.
70
What are the top clinical indications for benzodiazepines?
* Anxiety or agitation
* Insomnia (short-term)
* Pre-procedure sedation
* Muscle relaxation
* Seizure control (e.g., status epilepticus)
* Alcohol withdrawal (prevents seizures and reduces symptoms)
71
What is the key phrase to remember for benzodiazepine uses?
**Calming, relaxing, stopping seizures.**
72
Why are benzodiazepines used in alcohol withdrawal?
They prevent withdrawal seizures and decrease agitation.
73
Why are benzodiazepines useful for seizures?
They suppress excessive neuronal activity in the brain.
74
Why should benzodiazepines be used for insomnia only short-term?
They cause tolerance, dependence, and withdrawal when used long-term.
75
What type of glaucoma makes benzodiazepines contraindicated?
**Narrow-angle glaucoma** — they can worsen intraocular pressure.
76
Why are benzodiazepines contraindicated in pregnancy?
They may cause fetal harm, including floppy infant syndrome or newborn withdrawal.
77
What are the three major contraindications for benzodiazepines?
1. Allergy to benzodiazepines
2. Narrow-angle glaucoma
3. Pregnancy
78
What are the most important CNS adverse effects of benzodiazepines?
Sedation, drowsiness, confusion, amnesia, dizziness/ataxia, cognitive impairment.
79
Which population is most at risk for benzodiazepine-related falls?
Older adults due to sedation, ataxia, and confusion.
80
What is a key phrase to remember for the CNS effects of benzodiazepines?
Sedated, slow, and forgetful.
81
What is a paradoxical reaction to benzodiazepines?
Anxiety, agitation, or restlessness (opposite of calming).
82
What are some other common side effects of benzodiazepines?
Headache, nausea, dry mouth, constipation, hypotension, blurred vision.
83
What is the “hangover effect” associated with benzodiazepines?
Daytime sleepiness after nighttime dosing.
84
What combination greatly increases the risk of respiratory depression with benzodiazepines?
Opioids, alcohol, and other CNS depressants.
85
Why should benzodiazepines be tapered slowly when discontinuing?
To avoid withdrawal symptoms and rebound insomnia.
86
What long-term problems can develop with benzodiazepines?
Tolerance, dependence, and withdrawal if stopped abruptly.
87
What safety principle should nurses follow when giving benzodiazepines to older adults?
Use the lowest effective dose to reduce fall risk and confusion.
88
What symptom may occur if benzodiazepines are stopped abruptly after long-term use?
Rebound insomnia or other withdrawal symptoms.
89
What adverse effect makes benzodiazepines dangerous for people who live alone or use mobility aids?
Ataxia (poor coordination) → increases fall risk.
90
Why is confusion an important side effect to monitor in hospitalized or elderly patients?
It can mimic or worsen delirium.
91
What are the **key symptoms** of benzodiazepine overdose?
Extreme drowsiness, confusion, poor reflexes, dizziness, coordination loss, and possibly coma.
92
Do benzodiazepine overdoses usually cause fatal respiratory depression on their own?
**No.** Benzodiazepine overdose alone rarely causes severe breathing problems or death.
93
What substances make benzodiazepines **much more dangerous** when combined?
Alcohol, opioids, and barbiturates (other CNS depressants).
94
Why are combinations of benzodiazepines with alcohol or opioids dangerous?
They can cause **severe respiratory depression, hypotension, and death.**
95
What is the **first-line treatment** for benzodiazepine overdose?
**Supportive care**—monitor airway, breathing, vital signs, oxygen, hydration.
96
What medication can reverse benzodiazepine sedation?
**Flumazenil**.
97
How does flumazenil work?
It blocks benzodiazepines at **GABA receptors**, reversing sedation.
98
Why must flumazenil be used carefully?
It can trigger **seizures**, especially in chronic benzodiazepine users or mixed-substance overdoses.
99
Why does flumazenil cause withdrawal seizures in long-term benzo users?
Their brain has adapted to constant GABA enhancement; sudden reversal → **overexcited brain → seizures**.
100
What are the **NCLEX high-yield priorities** in benzo overdose?
* Monitor airway & breathing
* Identify CNS depression
* Treat with supportive care
* Use flumazenil only when appropriate
101
What is the typical mental state of someone with benzodiazepine overdose?
**Somnolence** (extreme drowsiness) and confusion.
102
What is the life-threatening danger when benzodiazepines are combined with fentanyl or alcohol?
**Respiratory depression leading to death.**
103
What do benzodiazepines do to GABA?
They **enhance GABA**, increasing CNS calming/sedation.
104
Why do benzodiazepines have many drug interactions?
They depress the CNS and are metabolized by liver enzymes (especially CYP450).
105
What type of substances cause the **most dangerous interaction** with benzodiazepines?
**CNS depressants** (e.g., alcohol, opioids, sedatives, muscle relaxants).
106
What happens when benzodiazepines are combined with opioids (like morphine or fentanyl)?
Extreme sedation, respiratory depression, hypotension, coma, and **risk of death**.
107
Why is alcohol dangerous when taken with benzodiazepines?
It causes **additive CNS depression**, increasing sedation and slowing breathing.
108
What is the key danger of combining benzodiazepines with other sleeping pills?
**Profound sedation** and loss of reflexes.
109
How does grapefruit juice interact with benzodiazepines?
It inhibits liver enzymes → benzos stay in the body longer → stronger effects → toxicity.
110
What symptoms may increase when benzodiazepines are taken with grapefruit juice?
Sedation, dizziness, confusion, and excessive CNS depression.
111
What herbal products interact with benzodiazepines by increasing sedation?
**Kava** and **valerian**.
112
What is the risk when combining kava/valerian with benzodiazepines?
Extreme drowsiness, impaired coordination, and **increased fall risk** (especially in older adults).
113
What medications slow the metabolism of benzodiazepines?
* Azole antifungals (ketoconazole) * Verapamil & diltiazem * Protease inhibitors * Macrolide antibiotics (erythromycin)
114
What happens when a medication slows benzodiazepine metabolism?
Benzos build up → stronger effects → excessive sedation → increased toxicity.
115
What is the **key takeaway** for benzodiazepine interactions?
**Anything that slows the CNS or slows liver metabolism increases sedation, toxicity, and respiratory depression.**
116
Which interaction is most likely to cause death?
Benzodiazepines **+ opioids** (due to severe respiratory depression).
117
diazepam
Long-acting benzodiazepine.
118
diazepam Uses
Anxiety, muscle spasms, seizures (especially status epilepticus), procedural sedation, alcohol withdrawal.
119
diazepam Pharmacokinetics
IV = immediate; PO = ~30 minutes.
120
diazepam Half-Life
It has a very long half-life (20–60 hours).
121
diazepam Clinical Importance
Because its long duration provides stable, long-lasting CNS calming.
122
diazepam Safety Note
Daytime sedation due to drug accumulation.
123
lorazepam
Intermediate-acting.
124
lorazepam Uses
Anxiety, acute seizure control (IV), short-term insomnia, procedural sedation.
125
lorazepam in Seizures
IV lorazepam is fast, reliable, and effective at stopping seizures.
126
lorazepam Onset
30–60 minutes.
127
lorazepam Duration
About 8 hours.
128
lorazepam Safety Note
Shorter duration → less accumulation and less daytime sedation.
129
midazolam
Short-acting.
130
midazolam Uses
Procedural sedation, pre-operative sedation, and producing amnesia.
131
midazolam Onset
1–5 minutes (very fast).
132
midazolam Duration
2–6 hours.
133
midazolam Safety Note
Respiratory depression — must monitor airway closely.
134
midazolam Memory Effect
It causes anterograde amnesia.
135
What are Z-drugs and what are they used for?
Short-acting hypnotics (non-benzodiazepines) used for **short-term insomnia**.
136
Do Z-drugs act on GABA receptors like benzodiazepines?
**Yes**, they enhance GABA, producing sedation.
137
Why do some patients prefer Z-drugs over benzodiazepines?
They cause **less daytime sedation** and **lower dependence risk**.
138
What is zopiclone mainly used for?
Short-term insomnia—helps with **sleep onset AND staying asleep**.
139
What is the onset of zopiclone?
About **30 minutes**.
140
What is the duration of zopiclone?
**6–8 hours**, helpful for people who wake up during the night.
141
What is zopiclone’s approximate half-life?
**5 hours**.
142
What is zolpidem mainly used for?
**Sleep-onset insomnia** (trouble falling asleep).
143
Why is zolpidem helpful for sleep initiation?
Very short-acting → less “hangover” and **less next-day drowsiness**.
144
Zolpidem pharmacokinetics (onset, half-life, duration)?
* Onset: ~30 min
* Half-life: **1.4–4.5 hr**
* Duration: ~6–8 hr
145
When should Z-drugs be taken?
**Right before bed**.
146
How much sleep time should a patient allow after taking a Z-drug?
**7–8 hours**.
147
What substances must be avoided with Z-drugs?
**Alcohol**, opioids, or benzodiazepines (risk of respiratory depression).
148
What is a key safety issue with Z-drugs in older adults?
**Fall risk** due to sedation.
149
What unusual side effects can occur, especially with zolpidem?
**Complex sleep behaviours** (sleepwalking, sleep-eating).
150
Should Z-drugs be used long-term?
**No**—short-term only due to risk of dependence.
151
What is a quick way to remember what Z-drugs do?
**“Z-drugs help you ZZZ.”**
152
Zopiclone vs. Zolpidem memory?
* **Zopiclone → helps you stay asleep**
* **Zolpidem → helps you fall asleep**
153
What do most OTC sleep aids contain?
Antihistamines that cause drowsiness (CNS depressant effect).
154
Which antihistamines are commonly used in OTC sleep aids?
Doxylamine (Unisom) and diphenhydramine (Benadryl, Sleep-Eze, Tylenol PM).
155
Why do antihistamines make you tired?
They block histamine in the brain → slows brain activity → sedation.
156
Are OTC sleep aids real prescription sleeping pills?
No—they just cause enough sedation to help someone fall asleep.
157
Why should alcohol never be mixed with OTC sleep aids?
Both are CNS depressants → can cause severe respiratory depression or respiratory arrest.
158
What is the main risk of combining alcohol with antihistamine sleep aids?
Breathing can slow or stop.
159
Are OTC hypnotics safe?
Generally yes when used correctly, but dangerous when combined with alcohol or taken in high doses.
160
What history should the nurse assess before administering hypnotics?
Allergies, current medications (including OTC), and medical history.
161
Which vital sign assessments are essential before giving hypnotics?
Baseline vitals, intake/output, supine and erect blood pressure.
162
What neurological findings should the nurse assess before giving CNS depressants?
Mental status, memory, cognitive function, mood, and alertness.
163
Why check lab results for kidney and liver function?
These organs metabolize and excrete hypnotics; dysfunction increases toxicity risk.
164
Why should patients check with the prescriber before taking additional medications?
Many OTC medications interact with hypnotics and increase sedation.
165
What may occur after stopping hypnotics taken for 3–4 weeks?
Rebound insomnia for several nights.
166
What is the overall focus of nursing assessment with hypnotics?
Ensuring safety, preventing oversedation, and identifying CNS depression risk factors.
167
When should hypnotics be administered for best effect?
**30–60 minutes before bedtime**, depending on the drug’s onset.
168
What sleep-related effect should you teach clients about with benzodiazepines?
**REM rebound** → can cause next-day tiredness.
169
Why use caution in older adults when giving hypnotics?
Higher risk for **falls, confusion, hangover effects**, and oversedation.
170
What should nurses teach before using medication for sleep?
**Non-pharmacological sleep strategies** (sleep hygiene, routines, relaxation).
171
What should patients avoid while taking hypnotics?
**Alcohol** and **other CNS depressants**.
172
What are examples of CNS depressants?
Opioids, alcohol, antihistamines, muscle relaxants, benzodiazepines.
173
What are key safety interventions for patients on hypnotics?
Use bed rails/alarms, assist older adults with ambulation, keep call light close, no driving.
174
What type of monitoring is essential for hypnotic use?
**Airway, breathing, circulation, and blood pressure.**
175
How do you monitor for therapeutic effects of hypnotics?
Improved sleep quality, fewer awakenings, shorter time to fall asleep, improved daytime well-being.
176
What are therapeutic goals for muscle relaxants (if used)?
Decreased rigidity, decreased spasticity, and improved comfort.
177
Why should patients keep a sleep journal?
To track sleep patterns and evaluate non-pharmacological strategies.
178
Why must patients check with a provider before taking OTC sleep meds?
To avoid **interactions with CNS depressants** or other medications.
179
What activities must patients avoid after taking hypnotics?
Driving, operating machinery, or tasks requiring alertness.
180
Why should hypnotics not be stopped abruptly?
They can cause **withdrawal**, **rebound insomnia**, **rebound anxiety**, and **seizures**.
181
Why are sedative-hypnotics not recommended long-term?
They are **addictive**, interfere with **REM sleep**, and lose effectiveness.
182
What should patients know about hangover effects?
They may be worse in **older adults** → monitor for daytime drowsiness and falls.
183
What food interaction should be taught?
**Avoid grapefruit**, which increases medication levels and sedation.
184
What are key elements of sleep hygiene to review?
Limit screens, keep consistent sleep routine, avoid caffeine late, dark/quiet room.
185
What happens to the brain if benzodiazepines are stopped abruptly?
It becomes **overstimulated** → anxiety, insomnia, irritability.
186
What are common withdrawal symptoms?
Panic, sweating, nausea, fast heart rate, tremors.
187
What is the most dangerous withdrawal symptom?
**Seizures** due to sudden CNS hyperactivity.
188
What is rebound insomnia?
Sleep problems returning **worse than before** after sudden stopping.
189
What is the correct way to discontinue benzodiazepines/hypnotics?
**Slow taper under medical supervision.**
190
What is anxiety?
An unpleasant state of dread or fear, often based on imagined, anticipated, or exaggerated threats.
191
What triggers anxiety disorders?
**Imagined or future threats** that create exaggerated worry and physical symptoms.
192
What physical symptoms can occur during anxiety?
Palpitations, sweating, stomach pain, shakiness, shortness of breath.
193
Name 4 anxiety disorders.
Separation anxiety, social anxiety, panic disorder, GAD (generalized anxiety disorder). (+ others: phobias, agoraphobia, panic attacks)
194
What is the most common mental health disorder?
**Depression.**
195
How long must symptoms last for a depression diagnosis?
At least **2 weeks** with a change in functioning.
196
List 3 hallmark symptoms of depression.
Depressed mood, loss of interest, appetite/sleep changes.
197
What cognitive symptoms occur in depression?
Difficulty concentrating, feelings of guilt/worthlessness, slowed thinking.
198
What thoughts may occur in severe depression?
Recurrent thoughts of death or suicidal ideation.
199
How do anxiolytics generally work?
They **reduce CNS overactivity** so the body and mind feel calmer.
200
Which neurotransmitter do anxiolytics enhance?
**GABA**, the brain’s main calming chemical.
201
Which “stress neurotransmitters” may be decreased?
Serotonin, norepinephrine, dopamine.
202
How do benzodiazepines work in anxiety?
Calm activity in the **brainstem** and **limbic system**.
203
When are benzodiazepines useful?
**Short-term anxiety** and **panic attacks** (fast acting).
204
Why aren't benzodiazepines good for long-term use?
Sedation, tolerance, dependence, withdrawal risk.
205
What makes buspirone different from benzodiazepines?
It is **non-sedating** and **non-habit-forming**.
206
What is buspirone best used for?
**Long-term management of chronic anxiety** (e.g., GAD).
207
Why is buspirone not useful in panic attacks?
It takes **2–4 weeks** to work (slow onset).
208
What dangerous interaction can occur with SSRIs + buspirone?
**Serotonin syndrome**.
209
Which medication class should *never* be combined with buspirone?
**MAOIs** → can cause hypertensive crisis.
210
What is the primary use of benzodiazepines in anxiety?
**Stopping anxiety quickly** (fast relief of acute symptoms).
211
What symptoms can benzodiazepines help with?
Agitation, tension, panic, anxiety-related insomnia.
212
What conditions besides anxiety can benzodiazepines treat?
Alcohol withdrawal, muscle spasms, seizures, insomnia, procedural sedation.
213
Do benzodiazepines treat long-term anxiety or depression?
**No** — they are only for **short-term** use.
214
What is the most common adverse effect of benzodiazepines?
**CNS depression** → sedation, drowsiness, slowed thinking.
215
What cardiovascular effect can benzodiazepines cause?
**Hypotension** (low blood pressure).
216
What is a paradoxical reaction to benzodiazepines?
Agitation, aggression, hyperactivity — the opposite of calming.
217
Why are benzodiazepines risky for older adults?
Increased sensitivity → sedation, confusion, **high fall risk**, longer drug duration.
218
Can benzodiazepines cause dependence?
**Yes** — they are habit-forming and can cause withdrawal.
219
What allergy contraindicates benzodiazepine use?
Allergy to the specific benzo.
220
Why are benzodiazepines contraindicated in narrow-angle glaucoma?
They increase eye pressure and can worsen the condition.
221
Why avoid benzodiazepines during pregnancy?
They can harm the fetus (withdrawal, floppy infant syndrome).
222
What CNS symptom appears in benzodiazepine overdose?
**Extreme sedation** or unresponsiveness.
223
What blood pressure issue appears in overdose?
**Dangerously low BP**.
224
Can benzodiazepine overdose cause respiratory depression?
Yes — especially with **other CNS depressants** (alcohol, opioids).
225
What dangerous event can occur if flumazenil is given to a chronic benzo user?
**Seizures** due to sudden withdrawal.
Pharm Lecture
flashcards
Decks in class (17)
# Cards
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Unit 1 (part 1)200
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Unit 2: Drugs Affecting The Autonomic NS278
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Unit 3: coagulation modifiers and anemia medications220
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Unit 3: coagulation modifiers and anemia medications163
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Unit 3: drugs for anemia75
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Lecture 4231
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Lecture 5: Drugs affecting the respiratory system245
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Lecture 6: Drugs Affecting GI131
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Lecture 7255
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Lecture 8184
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Lecture 9380
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Lecture 9 (Pt. 2)122
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Lecture 10225
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Lecture 10 pt. 2121
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Lecture 11168
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Lecture 11 (part 2)132
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Unit 12146
