Prescribing for the pregnant patient again
Describe to me the features of fetal alcohol syndrome, isotretinoin embropathy, Ebstein’s anomaly, fetal hydantoin syndrome, Mobius sequence
See images
These drugs have been known to cause anxiety
Anticholinergic, stimulants, OTC medications, Substance Abuse
what are some sleep enablers
orexin a and b peptides loss of orexin neurons =narcolepsy
orexin antagonists have sleep enabling effects suvorexant
Can you use Flumazenil to treat a benzo overdose?
Yes
List some of the directions for use
BID twice a day
PRN as needed
PO by mouth
HS bedtime
IVPB IV piggy back
TID 3X day
400 mcg is the normal dose of folate given to this age group of women
What is reproductive age
Why are benzos preferred over other drugs in the treatment of anxiety?
rapid onset of action, relatively high therapeutic index avalibility of antidote low risk of DD interactions minimal effects on CV or autonomic functions
give for a short term
abrupt discontinuance may lead to rebound insomnia
What is more toxic in overdose?
Alprazolam
What factors cause noncompliance
Asymptomatic illnesses continuously changing medications to find a better one dosage frequency patient factors packaging factors lack of transportation various cultural or personal beliefs
B-lactams and metronidazole are both common blanks used in pregnancy and their anticipated adverse effects are blank
Blactams - Late type hypersensitivity (rash/fever) Immediate-type (anaphylaxis) Seizures in high concentrations
Metronidazole Alcohol intolerance Metallic unpleasant taste Peripheral neuropathy with prolonged use ***Caution when tx BV or Trich***
The risk of dependency CNS depression amnestic effects additive cns depression with other drugs and affects psychomotor are some disadvantage of what?
what are benzodiazepines
What are used to treat sleep problems?
BZDs ZZZ Daytime sedation more common with Benzos zzzz have efficacy similar to BZDs in sleep disorders
What are contraindicated in acute intermittent porphyria variegate porphyria, hereditary coproporphyria or symptomatic porphyria
Barbituates
What can you do to improve compliance
enhanced communication assessment of personal social and economic conditions developing routine mailing of refil reminders by the pharmacist enlist patients active participation
Describe examples of drugs useful in fetal therapeutics
Corticosteroids Þ stimulates fetal lung maturation when preterm birth is expected
- Phenobarbital decrease incidence of jaundice in newborns (given to pregnant women near term)
- Zidovudine decrease transmission of HIV from the mother to the fetus
What are the first line of GAD and certain phobias?
what are SSRIS and SNRIs - slow onset and minimal effective in acute anxiety states
what are anxiolytics used for other than what was previously discussed?
insomnia sedation and amnesia before and during medical and surgical procedures treatment of epilepsy anesthesia withdrawal states in sedatives muscle relaxation diagnostic aid for treatment in psychiatry
List some common drug interactions with benzos
Alcohol opioid analgesics anticonvulsants phenothiazine antihistamines antihypertensives TCAs
Without a prescription what drugs can not be refilled?
Schedule II
What are some infections pathogens that can cause teratogens?
Rubella CMV Herpes Zika
What are some precautions of prescribing benzos
mental and motor function issues, giving most at bed time might be better prescribe for short weeks assess efficacy periodically avoid combining antianxiety drugs
Name some of the toxic effects of anxiolytics
See notes..... too long
Alterations in drug response can can cause
withdrawl symptoms, withdrawarl is less common with zzz although short acting longer acting chlordiazepoxide diazepam and phenobarbital
Why should you not prescribe a biologic if possible?
They're expensive