Core Concepts in Pharmacology Ch 07

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anxiety: state of apprehension & autonomic nervous system stimulation

results from exposure to unidentified threat
anxiolytics: drugs that relieve anxiety
barbiturates: class of drugs used to treat anxiety & insomnia
depressants: drugs that lower neuronal activity w/i the CNS
electroencephalogram (EEG): dx test that records brainwaves through electrodes attached to scalp
hypnotic: drug that causes sleep
insomnia: inability to fall asleep/stay asleep
limbic system: area in brain responsible for
emotion
learning
memory
motivation
mood

L earning
I nitiative (motivation)
M emory
B alanced...
I nternally (mood)
C aring (emotion)
non-REM sleep: characterized by little/no movement of eyes
rebound insomnia: increased sleeplessness

occurs when long-term anti-anxiety or hypnotic medication is d/c
REM sleep: characterized by quick, scanning movements of eyes
reticular formation: network of neurons along entire length of brain stem

connected w/reticular activating system
reticular activating system (RAS): brain structure that projects from brainstem & thalamus to cerebral cortex

responsible for sleeping & wakefulness

performs an alerting function

('activating' system responsible for 'alerting')
sedatives: drugs that relax or calm the client
sedative-hypnotic: drug that, when given in lower doses, produces a calming effect and, when given in higher doses, produces sleep
sleep debt: sleep deficit possibly accompanied by negative effects:

impaired judgment
depression
slowed reaction time
tranquilizer: drug that produces a calm/tranquil feeling
Benzodiazepines, barbiturates, and non-barbiturates are classified as CNS depressants. TRUE or FALSE: TRUE
Apprehension, tension, or uneasiness lasting for six months or longer and causing considerable stress is referred to as _____ _____.: generalized anxiety
Two important sets of brain structures are associated with anxiety. One connected with emotion is the 1_____ system; the other, projecting from the brain stem and connected with alertness, is the 2_____ _____ system.: 1) limbic

2) reticular activating
1_____ are classes of drugs prescribed to relax clients. Classes of drugs used to help clients sleep are 2_____.: 1) Sedatives

2) hypnotics
Diazepam (Valium) reduces anxiety by binding to a receptor in the brain referred to as the _____ _____ _____ _____ molecule.: GABA receptor-chloride channel
The drug class usually prescribed for short-term insomnia caused by anxiety is _____.: benxodiazepines
_____ is a class of drugs that reduces anxiety, causes drowsiness, and promotes sleep when administered at higher doses.: Barbiturates
_____ _____ is a fatal symptom often associated with an overdose of barbiturates or other CNS depressants.: Respiratory depression
Schedule 1_____ is the level assigned to many benzodiazepines, while Schedule 2_____ is the level assigned to some barbiturates.: 1) IV

2) III
The stage in which the client can still be easily awakened. This stage comprises the greatest amount of total sleep time. a. Non-REM Stage 1 b. Non-REM Stage 2 c. Non-REM Stage 3 d. Non-REM Stage 4 e. REM Sleep: b. Non-REM Stage 2
This is the deepest stage of sleep, a time during which nightmares occur in children. Sleepwalking is also a common behavior for this stage. a. Non-REM Stage 1 b. Non-REM Stage 2 c. Non-REM Stage 3 d. Non-REM Stage 4 e. REM Sleep: d. Non-REM Stage 4
At the onset of this stage of sleep, the client is in drowsy for about one to seven minutes. During this time, the client can be easily awakened. a. Non-REM Stage 1 b. Non-REM Stage 2 c. Non-REM Stage 3 d. Non-REM Stage 4 e. REM: a. Non-REM Stage 1
This stage is characterized by eye movement and loss of muscle tone. This is the stage when dreaming takes place. The mind is very active and resembles a normal waking state. a. Non-REM Stage 1 b. Non-REM Stage 2 c. Non-REM Stage 3 d.: e. REM Sleep
The client may move into or out of a deeper sleep at this stage. Heart rate and blood pressure fall; gastrointestinal activity rises. a. Non-REM Stage 1 b. Non-REM Stage 2 c. Non-REM Stage 3 d. Non-REM Stage 4 e. REM Sleep: c. Non-REM Stage 3
What is the class name and most appropriate use for secobarbital (Seconal)? a. bendoziazepine for anxiety & panic b. benzodiazepine for short-term releif of insomnia c. barbiturate for short-term relief of insomnia d. barbiturate: d. barbiturate for short-term sedation
What is the class name and most appropriate use for chlordiazepoxide (Librium)? a. bendoziazepine for anxiety & panic b. benzodiazepine for short-term releif of insomnia c. barbiturate for short-term relief of insomnia d. barbitur: a. bendoziazepine for anxiety & panic
What is the class name and most appropriate use for zolpidem (Ambien)? a. bendoziazepine for anxiety & panic b. benzodiazepine for short-term releif of insomnia c. barbiturate for short-term relief of insomnia d. barbiturate for s: e. non-barbiturate CNS depressant for short-term relief of insomnia
What is the class name and most appropriate use for prazepam (Centrax)? a. bendoziazepine for anxiety & panic b. benzodiazepine for short-term releif of insomnia c. barbiturate for short-term relief of insomnia d. barbiturate for: a. bendoziazepine for anxiety & panic
What is the class and the most appropriate use for amobarbital (Amytal)? a. benzodiazepine for anxiety & panic b. benzodiazepine for short-term relief of insomnia c. barbiturate for short-term relief of insomnia d. barbiturate for: c. barbiturate for short-term relief of insomnia

"AM(ytal) I sleepy yet?"
What is the class and the most appropriate use for triazolam (Halcion)? a. benzodiazepine for anxiety & panic b. benzodiazepine for short-term releif of insomnia c. barbiturate for short-term relief of insomnia d. barbiturate for: b. benzodiazepine for short-term relief of insomnia

"You should TRI(azolam) to sleep"
Episodes of immediate and intense apprehension, fearfulness, or terror refer to: a. anxiety b. panic c. phobia d. post-traumatic stress: b. panic
Drugs meant to address anxiety on a more limited basis are called: a. anxiolytics b. sedatives c. mood disorder drugs d. antidepressants: a. anxiolytics
The important brain center responsible for unconscious repsonses to extreme stress is the: a. limbic system b. reticular formation c. reticular activating system d. hypothalamus: d. hypothalamus
Which of the following terms may be used to describe benzodiazepines? a. sedative b. hypnotic c. tranquilizer d. all of the above: d. all of the above
One of the first drugs used for anxiety treatment was: a. alprazolam (Xanax) b. clonazepam (Klonopin) c. chloridiazepoxide (Librium) d. clorazepate (Tranxene): c. chlordiazepoxide (Librium)
Diazepam binds to the GABA receptor, resulting in an opening of what kind of channel? a. sodium b. potassium c. chloride d. calcium: c. chloride
Which of the following statements is true about reestablishing a healthful sleep regimen? a. Drinking alcohol close to bedtime helps one to sleep. b. Eating a moderate meal close to bedtime helps one to sleep. c. Supplements are often reco: c. Supplements are often recommended for insomnia.
Insomnia rebound: a. is a time during which insomina and symptoms of anxiety may worsen b. is a worsening of insomnia due to drug dependency c. is more common in younger clients d. develops from short-term use of insomnia medication: a. is a time during which insomina and symptoms of anxiety may worsen
The electroencephalogram: a. measures brain waves only when the client is awake. b. measures muscle activity of the eyes. c. may be used as a dx tool to identify insomnia, seizure activity, depression, and dementia. d. shows alpha wav: c. may be used as a dx tool to identify insomnia, seizure activity, depression, and dementia.
Which of the following is true regarding sleep stages and patterns? a. Drugs for insomnia generally do not affect sleep stages. b. Clients with normal sleep patterns move from non-REM to REM sleep about every 90 minutes. c. REM sleep is th: b. Clients with normal sleep patterns move from non-REM to REM sleep about every 90 minutes.
Barbiturates: a. act by blocking the GABA receptor-chloride channel molecule b. are safe during pregnancy c. are drugs of choice for anxiety d. must be used carefully to avoid respiratory depression: d. must be used carefully to avoid respiratory depression
Phenobarbital: a. is a short acting barbiturate and is therefore more useful for brief medical procedures b. stimulates liver enzymes and thereby may increase its own metabolism with repeated dosing c. is mainly limited in drug therapy to: b. stimulates liver enzymes and thereby may increase its own metabolism with repeated dosing
Diazepam: a. suppresses neuronal activity within the limbic system b. enhances impulses that might be transmitted to the reticular activating system c. has little effect if any on tolerance d. is relatively limited in its range of the: a. suppresses neuronal activity within the limbic system
Buspirone (Buspar): a. is a benzodiazepine b. may act by binding to brain dopamine and serotonin receptors c. is used for short-term treatment of insomnia d. all of the above: b. may act by binding to brain dopamine and serotonin receptors

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