Anti-Anxiety

Question 1

Most patients with generalized anxiety disorder and panic attacks are now being treated with what drugs?

Answer 1

antidepressants

Question 2

what percentage of americans seek oral care only when absolutely necessary?

Answer 2

20%

Question 3

what percentage of americans refuse to seek any dental care due to fear?

Answer 3

7%

Question 4

what are the most commonly prescribed antianxiety drugs?

Answer 4

benzos

Question 5

what is the mechanism of action of benzos?

Answer 5

enhance of facilitate the action of the neurotransmitter by exerting their effects in the CNS mediated by y-aminobutyric acid (GABA)

Question 6

what are the clinical effects of benzos?

Answer 6

low doses- anxiety and panic reduction
high doses- drowsiness and sleep

Question 7

which benzo is preferred for use in elderly patients?

Answer 7

phase 2 metabolism

Question 8

what drug may be used to reverse some of the effects of benzos?

Answer 8

Flumazenil (Romazicon)

Question 9

which of the following sleep stages is enhanced with the use of benzos?

Answer 9

Nonrapid eye movement (NREM) sleep stage 2

Question 10

which is the primary adverse reaction associated with the use of benzos for conscious sedation?

Answer 10

respiratory depression

Question 11

near- term administration of benzos to the mother has resulted in what adverse condition?

Answer 11

floppy infant syndrome

Question 12

because these agents are seldom absoultely needed, except for epilepsy, what type of patient should avoid benzos?

Answer 12

women who are or may become pregnant and nursing mothers

Question 13

what reduces the effectiveness of benzos?

Answer 13

smoking

Question 14

why are benzos indicated for epilepsy?

Answer 14

because they limit the spread of abnormal activity to other parts of the brain

Question 15

when benzos are used in dentistry to produce conscious sedation, what is used as an initial endpoint for dose administered?

Answer 15

appearance of ptosis

Question 16

what IV benzo is used for conscious sedation in the dental office?

Answer 16

Midazolam (Versed)

Question 17

once the patient uses a benzo before their dental appt and sees there is no reason to fear, what should be tried before the next appt?

Answer 17

try weaning them off of the medication by using nonpharmacologic sleep measures

Question 18

because the injectable barbs are highly irritating, how are they used?

Answer 18

IV not IM

Question 19

barbs act on nerves by enhancing the binding of which neurotransmitter to its receptor

Answer 19

GABA

Question 20

What is the therapeutic index of benzos in relation to barbs?

Answer 20

benzos are wider

Question 21

what can chronic use of barbs lead to?

Answer 21

physical and psychological dependence

Question 22

barbs are absolutely contraindicated in what patients?

Answer 22

intermittent porphyria or a positive family history of porphyria

Question 23

what is the longest acting barb

Answer 23

Phenobarbital (Luminal)

Question 24

what drug is unique in structure and action?

Answer 24

buspirone

Question 25

why is the pharmacologic effect of buspirone called anxioselective?

Answer 25

because of its selective anxiolytic action without hypnotic, anticonvulsant, or muscle-relaxant properties

Question 26

what drug is a rapid-acting hypnotic that is less potent and has a shorter duration of action than zolpidem?

Answer 26

zaleplon