anti-anxiety drugs Flashcards
progression of CNS-depressing effects
- anxiolysis
- sedation
- hypnosis
- anesthesia
- respiratory failure
relaxation, calmness, decreased motor activity w/o loss of consciousness
sedation
drowsiness, depressed state of consciousness and depressed motor activity resembling sleep, but with impaired sensory responsiveness
hypnosis
a state of unconsciousness w/o possibility of arousal
anesthesia (not produced by all sedative-hypnotic drugs)
the two major classes of sedation-hypnotic and anti-anxiety drugs
barbituates and benzodiazapines
how do barbituates and benzodiazepines differ in their effect on GABA-mediated channel opening?
- barbituates increase the duration of GABA-mediated channel opening
- benzodiazepines increase the frequency of GABA-mediated channel opening
which GABA receptor do barbituates and benzodiazepines bind to?
GABA A, but they bind at different allosteric sites to cause hyperpolarization and CNS depression
clinical effect of benzodiazepines
- CNS depression
- drowsiness and sedation
- amnesia sometimes
- anti-seizure
- muscle relaxant
- anti-anxiety effects at does that don’t produce ataxia or somnolence
benzodiazepine antagonist used to treat overdose, and recovery from benzodiazepine sedation (IV admin, reverse in 1-2 mins)
flumazenil
____________ have largely replaced once popular tranquilizers, have less potential for abuse, have better therapeutic index
benzodiazepines
_____________ is a non-benzodiazepine sedative-hypnotic but binds to the same site. it produces sedation at 1/10 dose required for muscle relaxation and 1/20 dose for seizure prevention. sedation w/in 15mins. t1/2 is 2-3 hrs. controlled release to treat insomnia
zolpidem (ambien) and related molecules
barbituates provide ______________ CNS suppression with RAS sensitivity
dose dependent
__________ is a long-acting barbituate used as an anti-convulsant.
phenobarbitol
_________, ________ and _____ are short acting sedative and hypnotic barbituates
pentobarbitol, secobarbitol, amobarbitol
_________ is an ultrashort acting IV induction of anesthesia barbituate.
thiopental
dental application: sedative-hypnotic drugs
barbituates
dental application: tx anxiety/ retrograde amnesia
bezodiazepine with local anesthetics
dental application: tx anesthetic-induced seizures
benzodiazepine
what is the first line of tx for all phases of bipolar disorder?
lithium salts
lithium salts are more effective in treating __________, but does augment other anti-depressants. MOA not known.
mania
