NURS 615 Exam 2 Study Guide
Anxiolytics
Benzodiazepines:
o Pharmacodynamics: Gamma Amio butyric acid (GABA) an
inhibitor neurotransmitter.
o Benzodiazepines increase the action of GABA, which reduces
the effect of neuronal excitation. Act on GABA receptor.
o This can result in reduction in anxiety, muscle relaxation,
ataxia, anticonvulsant activity.
o They are an agonist at the Gaba receptor, but they
INHIBIT the neurotransmitter.
o It reduces the activity through voltage dependent chloride channels.
o Examples:
o alprazolam (Xanax)
o Lorazepam (Ativan
o Temazepam (Restoril)
Buspar:
• Acts mainly in the Serotonin 1a receptor.
• It does have some activity at the dopamine receptor but be
sure to know that it primarily acts at the serotonin receptor.
• Short half-life, but slow onset of action.
• Absorbed well orally, should be taken with food to decrease
first-pass effect.
• Sometimes called an atypical anxiolytic.
• Approved for the use of GAD.
• Full agonist at the pre-synaptic serotonin receptor.
• Acts mainly at these receptors.
Antidepressants
SSRIs: Selective Reuptake Inhibitors:
• Examples:
o Paroxetine (Paxil)
o Fluoxetine (Prozac)
o Sertraline (Zoloft)
o Citalopram (Celexa)
o Escitalopram (Lexapro)
• Act at the Serotonin receptor
• These are indicated for MDD, GAD, OCD, PTSD, Panic
disorder and more.
, • They inhibit presynaptic neuronal reuptake of serotonin: this
allows more serotonin to be available to interact with the
postsynaptic receptor, then they are available for use in the
body.
• These are well absorbed orally and have a significant first-pass
effect. Metabolized by the CYP450 system. The majority are
eliminated through urine.
• Common adverse effects: nausea, dry mouth, headache,
sexual side effects
• Drug-drug interaction with Linezolid
• Patient Education: It is important to take medication at the
same time every day. Inform patients of potential side effects.
Inform patients when they can expect to notice an
improvement in their symptoms. It will take up to two weeks
until they see side effects.
Serotonin Syndrome Symptoms:
• HA, nausea, diarrhea, tremors or muscle spasms, rapid heart
rate, high blood pressure, disorientation or hallucinations,
intense anxiety, high fever, seizures, coma and death.
SNRIs:
• Examples:
o Venlafaxine (Effexor)
o Duloxetine (Cymbalta)
o Venlafaxine (Effexor): At lower doses this predominately
affects serotonin reuptake.
• These block serotonin and norepinephrine transporters,
inhibiting the reuptake of the neurotransmitters.
Tricyclic antidepressants:
• Mechanism of action: inhibit the reuptake of serotonin and
norepinephrine in the presynaptic neuron. They also act on
histamine and acetylcholine. Used for neuropathic pain (Elavil
with elderly patients) and off labels. These meds were
prescribed before SNRI and SSRI.
• Contraindications: patients with CV disease, uncontrolled
epilepsy, urinary retention, angle-closure glaucoma. It is
possible to overdose on these. Choose patients carefully to
avoid overdose.
Atypical antidepressants:
• Bupropion (Wellbutrin): Norepinephrine-Dopamine Reuptake
Inhibitors. Uptake of NE and dopamine are weakly inhibited.
These can cause insomnia. Take in the morning.
• Contraindications: patients with seizure disorder or conditions
increase the risk for seizure disorder. Angle-closure glaucoma.
Anticonvulsants
Carbamazepine (Tegretol):
Anxiolytics
Benzodiazepines:
o Pharmacodynamics: Gamma Amio butyric acid (GABA) an
inhibitor neurotransmitter.
o Benzodiazepines increase the action of GABA, which reduces
the effect of neuronal excitation. Act on GABA receptor.
o This can result in reduction in anxiety, muscle relaxation,
ataxia, anticonvulsant activity.
o They are an agonist at the Gaba receptor, but they
INHIBIT the neurotransmitter.
o It reduces the activity through voltage dependent chloride channels.
o Examples:
o alprazolam (Xanax)
o Lorazepam (Ativan
o Temazepam (Restoril)
Buspar:
• Acts mainly in the Serotonin 1a receptor.
• It does have some activity at the dopamine receptor but be
sure to know that it primarily acts at the serotonin receptor.
• Short half-life, but slow onset of action.
• Absorbed well orally, should be taken with food to decrease
first-pass effect.
• Sometimes called an atypical anxiolytic.
• Approved for the use of GAD.
• Full agonist at the pre-synaptic serotonin receptor.
• Acts mainly at these receptors.
Antidepressants
SSRIs: Selective Reuptake Inhibitors:
• Examples:
o Paroxetine (Paxil)
o Fluoxetine (Prozac)
o Sertraline (Zoloft)
o Citalopram (Celexa)
o Escitalopram (Lexapro)
• Act at the Serotonin receptor
• These are indicated for MDD, GAD, OCD, PTSD, Panic
disorder and more.
, • They inhibit presynaptic neuronal reuptake of serotonin: this
allows more serotonin to be available to interact with the
postsynaptic receptor, then they are available for use in the
body.
• These are well absorbed orally and have a significant first-pass
effect. Metabolized by the CYP450 system. The majority are
eliminated through urine.
• Common adverse effects: nausea, dry mouth, headache,
sexual side effects
• Drug-drug interaction with Linezolid
• Patient Education: It is important to take medication at the
same time every day. Inform patients of potential side effects.
Inform patients when they can expect to notice an
improvement in their symptoms. It will take up to two weeks
until they see side effects.
Serotonin Syndrome Symptoms:
• HA, nausea, diarrhea, tremors or muscle spasms, rapid heart
rate, high blood pressure, disorientation or hallucinations,
intense anxiety, high fever, seizures, coma and death.
SNRIs:
• Examples:
o Venlafaxine (Effexor)
o Duloxetine (Cymbalta)
o Venlafaxine (Effexor): At lower doses this predominately
affects serotonin reuptake.
• These block serotonin and norepinephrine transporters,
inhibiting the reuptake of the neurotransmitters.
Tricyclic antidepressants:
• Mechanism of action: inhibit the reuptake of serotonin and
norepinephrine in the presynaptic neuron. They also act on
histamine and acetylcholine. Used for neuropathic pain (Elavil
with elderly patients) and off labels. These meds were
prescribed before SNRI and SSRI.
• Contraindications: patients with CV disease, uncontrolled
epilepsy, urinary retention, angle-closure glaucoma. It is
possible to overdose on these. Choose patients carefully to
avoid overdose.
Atypical antidepressants:
• Bupropion (Wellbutrin): Norepinephrine-Dopamine Reuptake
Inhibitors. Uptake of NE and dopamine are weakly inhibited.
These can cause insomnia. Take in the morning.
• Contraindications: patients with seizure disorder or conditions
increase the risk for seizure disorder. Angle-closure glaucoma.
Anticonvulsants
Carbamazepine (Tegretol):
