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A comprehensive set of questions and answers related to the pharmacology and neurobiology of anxiety, sleep, and pain. It covers key medications, their mechanisms of action, and their clinical applications in treating various conditions. The document also explores the neuroanatomical and neurochemical basis of these disorders, providing insights into the underlying brain circuitry and neurotransmitter systems involved. This resource is valuable for students and professionals seeking to deepen their understanding of these complex topics.
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What is the medication that is the antidote for alprazolam? - Correct Answer-flumazenil What is the MOA of pregabalin that makes it alleviate pain for people with fibromyalgia or chronic fatigue? - Correct Answer-binds to the alpha 2 delta sub-units of voltage sensitive calcium channels What is an antagonist of caffeine - Correct Answer-adenosine Diagnose this pt: Patient comes in with a CC of anxiety. She has been excessively worrying, increased arousal, increased tiredness and irritability. What is the primary and least likely diagnosis? - Correct Answer-GAD; Panic Disorder Somebody w/ anxiety worries about having a panic attack, in addition has mood changes to avoid things in order to not have a panic attack. - Correct Answer-Panic disorder A woman was raped, and continues to have fear of opposite sex on her way to parking garage. Which two areas of the brain are involved? - Correct Answer-amygdala and hippocampus MOA of modafinil (Provigil). How does it promote normal wakefulness - Correct Answer- histamine, NE at alpha adrenergic receptor sites, dopamine at D2 receptors What is the MOA of eszopiclone? What receptors does it act on? - Correct Answer- Binds to GABA receptors to increase GABA to increase sleepiness Which would be the first line appropriate pharmacological agent for PTSD? - Correct Answer-Paroxetine What mediation is used to alleviate to help cognitive pain and physical symptoms in fibromyalgia? - Correct Answer-Milnacepran (Savella) With the difficulty breathing is related hypothetically to the activation of what area of the brain? - Correct Answer-parabrachial nucleous What medications are good for falling asleep "sleep induction" and are not addictive? - Correct Answer-Suvorexant (Belsmora) Know the MOA of buspirone. Which receptor does it primarily act upon? - Correct Answer-serotonin 1a 5HT1A partial agonist
How does melatonin improve sleep? What receptors does it act on? Agonist or antatonist? - Correct Answer-Secreted by the pineal glad to attach to receptors in the suprachiasmic nucleus to regulate the circadian rhythm; agonist Current dx of generalized anxiety disorder (GAD), difficulty concentrating as well as problems falling asleep. She gets very angry over basic things and is very moody in general, excessive stressful reactions, concentrate, irritability. What is going on in her brain? - Correct Answer-a. Dysfunction of amygdale and CTSC (serotonin/nor- einephrine) Pt is coming in for detox with a long hx of alcohol abuse, HTN, and cirrhosis. He reports 12 beers daily for weeks. Has w/d seizures when he tries to stop drinking on his own. So he has elevated AST, LFT....what agent would you choose to detox him? - Correct Answer-lorazepam Someone comes in with chronic hepatitis, also has chronic neuropathic pain. What medication would you AVOID prescribing to this patient and why? - Correct Answer- Cymbalta; elevates LFTs Benzodiazepine patient education - Correct Answer-Avoid ETOH may cause dizziness, may slow heart rate, avoid sedating antihistamines What medication or drug class, is second line treatment for fibromyalgia? - Correct Answer-cyclobenzaprine What drug is a melatonin receptor agonist? - Correct Answer-ramelteon, tasimeltion What is the MOA of trazodone? - Correct Answer-5HT2C antagonist, H1 antagonist What is the MOA of lorazepam? - Correct Answer-positive allosterioc modulator binds to GABA Which neurotransmitter is affected by light and activity? - Correct Answer-Melatonin What condition does this describe a. worry, anxiety, arousal, fatigue, sleeplessness, muscle tension? - Correct Answer-GAD What condition does this describe anticipatory anxiety, worry about panic, unexpected panic attacks, trying to avoid future attacks? - Correct Answer-Panic disorder What condition does this describe anxiety/fear over social performance? - Correct Answer-social anxiety disorder What condition does this describe anxiety while re-experiencing, increased arousal and startle responses, nightmares? - Correct Answer-PTSD
What area of the brain controls sleep "off switch" - Correct Answer-ventrolateral preoptic nucleus What area of the brain controls wake "on switch" - Correct Answer-tuberomammillary nucleus Name 2 additional receptors that regulate sleep and wake - Correct Answer-Orexin and hypocretin What are the S/E of taking Benadryl for sleep? If you are taking long term what are some symptoms you may experience? - Correct Answer-dizziness, xerostomia, memory loss What neuron is only activiated by a noxious stimulous? - Correct Answer-nociceptor what is the drug class of benzodiazepines for sleep? - Correct Answer-sedative hypnotics What medication should be used for severe anxiety attacks for people currently taking opioids for pain? - Correct Answer-SSRI What education would you give to a patient taking zolpidem - Correct Answer-do not take with food, avoid driving or hazardous actvity after taking medication, monitor for impairment the next moring