Ang zio lytics

Question 1

MOA for benzo

Answer 1

Facilitates GABAergic ChLoride channels
GABA = inhibitory NT
Want more GABA
Too much NT in anxiety and seizures

Question 2

DDX for anxiety?

RX for anxiety

Answer 2

GAD 
panic disorder
anxiety ass w depression
anxiety secondary to medical condition
insomina
alcohol withdrawal
RX:  (use Benzo's and non-benzos)

Question 3

Association with Alcohol

Answer 3

cross reaction since hit same receptors

good for withdrawal

Question 4

What is the caution with benzo’s?

which patients to avoid use with?

Answer 4

tolerance and withdrawal

avoid with pts with drug and alcohol abuse

Question 5

long half life benzo’s?
Good for?
Bad for?
Taper?

Answer 5

Diazepam (valium) and chlordiazepoxide (librium)
less withdrawal risk
more risk of falls and cognitive impairment
Taper if used more than 2 weeks

Question 6

short half-life benzo’s
good for?
How to taper?

Answer 6

alprazolam (xanax) and lorazepam (ativan)
PRN use
less risk of falls and cognitive impairment
Taper 10-20% every 1-2 weeks

Question 7

patient education with Benzo’s

Answer 7

ataxia
driving
withdrawal (esp with routine use (2-3x/d)
no alcohol

Question 8

how to Tx alcohol withdrawl???

Answer 8

Lorezepam (ativan) 1-2mg PO q 2 hr prn till ETOH withdrawal is over
DONT FORGET THIAMINE

Question 9

1st line RX for GAD and panic

Answer 9

1ST try Bu spir one (Buspar)
non-benzodiazepine
no tolerance and no sedation
takes weeks to work