PHAR 672: CNS Drugs & Anxiety Disorders
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Questions and Answers

Which neurotransmitters are primarily involved in Generalized Anxiety Disorder (GAD)?

  • Histamine and Endorphins
  • Norepinephrine and Serotonin (correct)
  • Dopamine and GABA
  • Acetylcholine and Glutamate

    • What role does norepinephrine (NE) play in anxiety symptoms according to the Excitatory-Inhibitory Neurotransmitter Theory?

  • Increases anxiety symptoms (correct)
  • Decreases anxiety symptoms
  • Has no effect on anxiety symptoms
  • Regulates serotonin levels

    • How does GABA influence anxiety symptoms according to the theory presented?

  • Blocks serotonin receptors
  • Increases norepinephrine levels
  • Has no relation to anxiety
  • Decreases anxiety symptoms (correct)

    • Which of the following is a potential treatment strategy for Generalized Anxiety Disorder?

    <p>Psychotherapy</p> Signup and view all the answers

    Which drug class is specifically associated with the treatment of Generalized Anxiety Disorder among the options listed?

    <p>SSRIs</p> Signup and view all the answers

    The locus coeruleus is primarily linked to which neurotransmitter's function in anxiety?

    <p>Norepinephrine</p> Signup and view all the answers

    What is the outcome of increased activity of GABA neurons in relation to anxiety symptoms?

    <p>Decrease in anxiety symptoms</p> Signup and view all the answers

    Why might a healthcare provider choose SSRIs over other medications for treating GAD?

    <p>They are less likely to cause withdrawal symptoms</p> Signup and view all the answers

    Which other medication types are suggested for GAD treatment besides SSRIs?

    <p>SNRIs and TCAs</p> Signup and view all the answers

    What is the maximum single dose for memantine?

    <p>5 mg</p> Signup and view all the answers

    Which of the following is a side effect of memantine?

    <p>Fatigue</p> Signup and view all the answers

    Which glaucoma medication must be stored refrigerated?

    <p>Bimatoprost</p> Signup and view all the answers

    What condition is characterized by too much pressure inside the eye?

    <p>Glaucoma</p> Signup and view all the answers

    Which of the following medications is NOT listed as requiring refrigeration?

    <p>Travoprost</p> Signup and view all the answers

    What is an indication for the use of memantine?

    <p>Alzheimer's disease</p> Signup and view all the answers

    What is a crucial administration instruction for Gralise?

    <p>It should be taken with food.</p> Signup and view all the answers

    Which adverse effect is associated with Gabapentin?

    <p>Somnolence</p> Signup and view all the answers

    What condition is primarily associated with the loss of dopamine neurons?

    <p>Parkinson's disease</p> Signup and view all the answers

    What is a common counseling point for patients taking Carbidopa-levodopa?

    <p>It's essential to take the drug at the same time every day.</p> Signup and view all the answers

    Which of the following is an appropriate precaution for Donepezil?

    <p>May worsen asthma symptoms.</p> Signup and view all the answers

    Which potential side effect is not associated with Pramipexole?

    <p>Asymmetrical body movements</p> Signup and view all the answers

    What should patients do to avoid CNS depression while taking Ropinirole?

    <p>Avoid alcohol and opioids.</p> Signup and view all the answers

    What should patients report while on Neurontin?

    <p>Unexplained muscle pain</p> Signup and view all the answers

    Which statement correctly reflects the effect of acetylcholine breakdown in Alzheimer's treatment?

    <p>Increased acetylcholine levels improve cognitive function.</p> Signup and view all the answers

    What typically happens if a patient abruptly stops taking their Parkinson's medication?

    <p>Patients may experience withdrawal symptoms.</p> Signup and view all the answers

    What is a common adverse drug reaction associated with paroxetine?

    <p>Sexual dysfunction</p> Signup and view all the answers

    Which drug class does alprazolam belong to?

    <p>Benzodiazepines</p> Signup and view all the answers

    Which of the following medications is primarily used for sleep disturbances?

    <p>Zolpidem</p> Signup and view all the answers

    What is the recommended action regarding grapefruit when taking lorazepam?

    <p>Avoid taking it with grapefruit or juice.</p> Signup and view all the answers

    What potential issue may arise when combining benzodiazepines with opioids?

    <p>Risk of sedation and respiratory depression</p> Signup and view all the answers

    What type of drug is fluoxetine, and what is a notable adverse effect?

    <p>SSRI; Nausea</p> Signup and view all the answers

    What is the general time frame for SSRIs or SNRIs to show antianxiety effects?

    <p>8-12 weeks</p> Signup and view all the answers

    Which of the following is NOT an adverse effect of buspirone?

    <p>Sedation</p> Signup and view all the answers

    Which drug is indicated for managing anxiety but also comes with a black box warning for sedation?

    <p>Zolpidem</p> Signup and view all the answers

    What complication is associated with long-term use of venlafaxine?

    <p>Hypertension</p> Signup and view all the answers

    Which class of drugs does Lisdexamfetamine belong to?

    <p>CNS Stimulants</p> Signup and view all the answers

    What is a significant adverse drug reaction associated with Amphetamine-Dextroamphetamine?

    <p>High Potential for Misuse &amp; Abuse</p> Signup and view all the answers

    What counseling point is important for patients prescribed Atomoxetine?

    <p>It should not be crushed or chewed.</p> Signup and view all the answers

    Which of the following is primarily associated with epilepsy?

    <p>Two or more episodes of unprovoked seizures</p> Signup and view all the answers

    Which neurotransmitter deficiency could lead to increased seizure activity?

    <p>GABA</p> Signup and view all the answers

    What adverse effect is common with Methylphenidate?

    <p>Weight loss</p> Signup and view all the answers

    Which medication is indicated for its potential to cause suicidal ideation in children and adolescents?

    <p>Atomoxetine</p> Signup and view all the answers

    What is a notable side effect of Atomoxetine?

    <p>Fatigue</p> Signup and view all the answers

    Which counseling point is essential when prescribing ADHD drugs?

    <p>Only take if needed for symptom control.</p> Signup and view all the answers

    Which class of drugs is Dexmethylphenidate part of?

    <p>CNS Stimulants</p> Signup and view all the answers

    Study Notes

    Anxiety Disorders

    • Generalized Anxiety Disorder (GAD) involves neurotransmitters norepinephrine and serotonin.
    • The Excitatory-Inhibitory Neurotransmitter Theory illustrates how norepinephrine increases anxiety while GABA neurons decrease it.

    Treatment Strategies for GAD

    • Psychotherapy is the primary non-pharmacological treatment.
    • Medications include:
      • SSRIs (Selective Serotonin Reuptake Inhibitors)
      • SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
      • TCAs (Tricyclic Antidepressants)

    Common Medications for GAD

    • SSRIs:
      • Citalopram (Celexa) - Side effects include sleep disturbances.
      • Escitalopram (Lexapro) - Can cause anxiety.
      • Fluoxetine (Prozac) - Possible diarrhea.
      • Paroxetine (Paxil) - May lead to sexual dysfunction and hyponatremia.
      • Sertraline (Zoloft) - Risk of bleeding.
    • SNRIs:
      • Venlafaxine (Effexor) - Side effects include nausea and dry mouth.
      • Desvenlafaxine (Pristiq) - Potential for constipation and hypertension.
      • Duloxetine (Cymbalta) - Risk of sexual dysfunction and hyponatremia.
    • TCAs:
      • Amitriptyline (Elavil) - Known for anticholinergic effects.
      • Nortriptyline (Pamelor) - Can cause drowsiness and weight gain.

    Temporary Anxiolytics for GAD

    • Medications include:
      • Alprazolam (Xanax)
      • Clonazepam (Klonopin)
      • Diazepam (Valium)
      • Lorazepam (Ativan)
      • Buspirone (Buspar)
      • Hydroxyzine (Atarax, Vistaril) - Antihistamine.

    Benzodiazepines Overview

    • Various benzodiazepines have different onset times and durations of action.
    • Many are fast-acting and may cause sedation or have a risk of respiratory depression when combined with opioids or alcohol.

    Neurotransmitters Involved in ADHD

    • Norepinephrine and dopamine are key neurotransmitters in Attention Deficit Hyperactivity Disorder.

    ADHD Medications

    • CNS Stimulants:
      • Amphetamine-Dextroamphetamine (Adderall)
      • Lisdexamfetamine (Vyvanse)
      • Methylphenidate (Ritalin, Concerta)
      • Dexmethylphenidate (Focalin)
    • Norepinephrine-Dopamine Reuptake Inhibitor:
      • Atomoxetine (Strattera).

    Seizures and Epilepsy

    • Epilepsy is characterized by two or more unprovoked seizures.
    • Seizures may present as convulsions or abnormal movements.

    Pathophysiology of Seizures

    • Insufficient GABA activity leads to inadequate inhibition, causing excessive neuron firing.

    Neurodegenerative Disorders

    • Includes Alzheimer’s Disease and Parkinson’s Disease.
    • Alzheimer’s involves a loss of acetylcholine neurons, leading to dementia.
    • Parkinson’s involves a loss of dopamine neurons, affecting motor control.

    Medications for Parkinson's Disease

    • Carbidopa-Levodopa (Sinemet, Sinemet CR) - May discolor urine and has nausea as a side effect.
    • Pramipexole (Mirapex) - Can cause drowsiness and hallucinations.
    • Ropinirole (Requip) - Has nausea and orthostasis as common effects.

    Medications for Alzheimer's Disease

    • Donepezil (Aricept) - Side effects include nausea and potential QTc prolongation.### COPD and Medications
    • Memantine (brand name Namenda) is used for treating confusion.
    • Dosage for Memantine should not exceed 5 mg; for patients requiring 10 mg, administration should be twice daily (BID).
    • Memantine increases glutamate receptor activities, potentially influencing cognitive functions.
    • Common side effects of Memantine include dizziness, headache, and fatigue.

    Ophthalmic Agents for Glaucoma

    • Glaucoma is characterized by excess intraocular pressure, which can lead to vision loss if untreated.
    • Various ophthalmic agents are available for managing glaucoma, some requiring refrigeration.

    List of Ophthalmic Agents

    • Bimatoprost: Brand name Lumigan; must be stored refrigerated.
    • Brimonidine: Brand name Alphagan P.
    • Dorzolamide-timolol: Brand name Cosopt.
    • Latanoprost: Brand names Xalatan, Xelpros; must be stored refrigerated.
    • Timolol: Brand names Timoptic, Betimol, Istalol.
    • Travoprost: Brand name Travatan Z; must be stored refrigerated.

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    Central Nervous System (CNS) Drugs Part II PDF

    Description

    This quiz focuses on the role of neurotransmitters in Generalized Anxiety Disorder (GAD) and the Excitatory-Inhibitory Neurotransmitter Theory. It is part of the PHAR 672 course on CNS Drugs taught by Dr. Lee in Fall 2024. Test your understanding of how norepinephrine and serotonin contribute to anxiety disorders.

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