AGENTS, CONTROLLING THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM - Anxiolytic agents Flashcards
Anxiolytics are used to treat
Neurosis
Anxiolytic agents should
Reduce anxiety and exert a calming effect
Anxiolytics are also useful for
- Treatment of epilepsy and seizures
- Insomnia
- Muscle relaxation in specific neuromuscular disorders
Indicate the agents of choice in the treatment of most anxiety states
Benzodiazepines
The choice of benzodiazepines for anxiety is based on
- A relatively high therapeutic index
- Availability of flumazenil for treatment of overdose
- A low risk of physiologic dependence
Which anxiolitics is a benzodiazepine derivative
Clordiazepoxide
Indicate the benzodiazepine, which has the shortest elimination half-life
Triazolam
Which benzodiazepines has the shortest duration of action?
Triazolam
Which benzodiazepines is less likely to cause cumulative and residual effects with multiple doses?
Lorazepam
Anxiolytic dosage reduction is recommended
- In patients taking cimetidine
- In patients with hepatic dysfunction
- In elderly patients
Which benzodiazepines is preferred for elderly patients?
Triazolam
Which anxiolytics is preferred in patient with limited hepatic function?
Buspirone
Indicate the mechanism of hypnotic benzodiazepine action
Increasing the frequency of Cl- channel opening events
Which anxiolytics is a partial agonist of brain 5-HT1A receptors?
Buspirone
Indicate the competitive antagonist of BZ receptors
Flumazenil
Indicate the agent, which interferes with GABA binding
Bicuculline
Antianxiety agents have
- Sedative and hypnotic activity
- Muscle relaxing and anticonvulsant effects
- Amnesic properties
Which disadvantages does not limit using benzodiazepines as antianxiety agents?
A high risk of drug interactions based on liver enzyme induction
Indicate the anxiolitic agent, which relieves anxiety without causing marked sedative effects
Buspirone
Which anxiolytics has minimal abuse liability?
Buspirone
In contrast to benzodiazepines, buspirone
Causes less psychomotor impairment and does not affect driving skills
Which sedative-hypnotic drugs does not potentiate the CNS depressant effects of ethanol, phenothiazines, or tricyclic antidepressants?
Buspirone
Limitation of buspirone is
An extremely slow onset of action
Which drugs may be used as antianxiety agents?
- BETA-blocking drugs
- Clonidine - a partial agonist of alfa2 receptors
- Tricyclic antidepressants
Which benzodiazepines is more likely to cause “hangover” effects such as drowsiness, dysphoria, and mental or motor depression the following day?
Clorazepat
Additive CNS depression can be predicted if benzodiazepines are used with
- Ethanol
- Morphine
- Clorpromazine
Which dosage of benzodiazepines for 60-90 days may produce severe withdrawal symptoms?
50-60 mg/d
Restlessness, anxiety, orthostatic hypotension, generalized seizures, severe tremor, vivid hallucination, and psychosis are possible symptoms of
Withdrawal
Flumazenil is used to
- Reverse the CNS depressant effects of hypnotic benzodiazepines overdose
- Hasten recovery following use of hypnotic benzodiazepines in anesthetic and diagnostic procedure
- Reverse benzodiazepine-induced respiratory depression
Flumazenil given intravenously
Acts rapidly but has a short half-life
