A patient who is complaining of anxiety and difficulty sleeping ...

[kodithompson]

A patient who is complaining of anxiety and difficulty sleeping has asked what prescription medications would assist in getting to sleep. What would be appropriate responses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
 
  1. Diphenhydramine (Benadryl)
  2. Valerian root
  3. Ramelteon (Rozerem)
  4. Flurazepam (Dalmane)
  5. Zolpidem (Ambien)

Question 2

Which situation would lead to an increase in cardiac output?
 
  1. Reduced cardiac contractility
  2. Hypovolemia
  3. Peripheral vascular resistance
  4. Increase in preload

[chereeb]

Answer to Question 1

3,4,5
Rationale 1: Diphenhydramine (Benadryl) can be obtained over the counter and does not need a prescription to obtain. It does promote getting to sleep.
Rationale 2: Valerian is an herbal product that does not need a prescription to obtain. It does promote getting to sleep.
Rationale 3: Rozerem is a newer, nonbenzodiazepine hypnotic approved to treat chronic insomnia in people who have problems falling asleep.
Rationale 4: Benzodiazepines are drugs of choice for generalized anxiety disorder and the short-term therapy of insomnia. Flurazepam (Dalmane) should be taken at bedtime because it quickly produces significant drowsiness.
Rationale 5: Ambien is a sedative-hypnotic approved for short-term treatment of insomnia.
Global Rationale: Rozerem is a newer, nonbenzodiazepine hypnotic approved to treat chronic insomnia in people who have problems falling asleep. Benzodiazepines are drugs of choice for generalized anxiety disorder and the short-term therapy of insomnia. Flurazepam (Dalmane) should be taken at bedtime because it quickly produces significant drowsiness. Ambien is a sedative-hypnotic approved for short-term treatment of insomnia. Diphenhydramine (Benadryl) can be obtained over the counter and does not need a prescription to obtain. It does promote getting to sleep. Valerian is an herbal product that does not need a prescription to obtain. It does promote getting to sleep.

Answer to Question 2

4
Rationale 1: A reduction in cardiac contractility results in lower preload and subsequent cardiac output.
Rationale 2: Hypovolemia is a lower blood volume and will result in lower cardiac output.
Rationale 3: Peripheral vascular resistance increases afterload and increases the workload on the heart.
Rationale 4: Increased preload results in a more forceful contraction and increases cardiac output.
Global Rationale: Increased preload results in a more forceful contraction and increases cardiac output. A reduction in cardiac contractility results in lower preload and subsequent cardiac output. Hypovolemia is a lower blood volume and will result in lower cardiac output. Peripheral vascular resistance increases afterload and increases the workload on the heart.

[kodithompson]

Excellent

[Dominic]

TYSM