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Phar 301 > Anti-Anxiety Drugs > Flashcards

Anti-Anxiety Drugs Flashcards

1
Q

What are three characteristics of anxiety?

A

Adaptive
Pathological
Anticipatory

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2
Q

3 main types of anxiety

A

Gen anxiety disorder
Panic disorder
Phobias

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3
Q

What are 4 proposed treatments for GAD?

A

Antidepressants, especially SSRIs
Benzodiazepines (eg. Diazepam)
Beta blockers (propranolol) if somatic
Buspirone (5-HT1A partial agonist)

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4
Q

What are 2 proposed treatments for Panic Disorder?

A

Benzodiazepines

Antidepressants

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5
Q

What are the proposed treatments for social and specific phobias?

A

Social - beta blockers

Specific - Therapist sessions

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6
Q

What is the comorbidity of GAD?

A

Other anxiety disorders and Major Depression

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7
Q

Who gets GAD?

A

Everyone

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8
Q

Diazepam has similar distribution patterns to which kind of receptor?

A

GABA-A

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9
Q

Diazepam _____ GABA receptors’ affinity to GABA

A

Increases

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10
Q

GABA and GABA agonists ______ Diazepam binding

A

Increase

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11
Q

What three parameters describe GABA-A receptor activity?

A

Probability of opening
Open time
Conductance

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12
Q

Benzodiazepines mainly do what to GABA receptors?

A

They increase the probability of the channel opening

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13
Q

Barbiturates do what to GABA receptors?

A

Prolong channel opening

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14
Q

True/False? GABA-A receptors have only one binding site

A

False

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15
Q

True/False? All Benzodiazepines have roughly the same pharmacokinetics

A

False

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16
Q

What properties to Benzodiazepines share? (4)

A

Rapid brain entry, slow redistribution (IV diazepam)
Active metabolites
Binding to plasma proteins
Enterohepatic recycling

17
Q

What is the main active metabolite in benzodiazepines?

A

Nordiazepam

18
Q

Why do Benzodiazepines have a long duration of action?

A

Clearance is reduced due to plasma protein binding

19
Q

What are the three main effects of benzodiazepines? What receptors are affected?

A

Sedation
Muscle relaxation
Anticonvulsant

GABA-A receptors presenting alpha 1 subunit

20
Q

Which receptors produce anxiolytic effects when affected?

A

Noradrenergic alpha 2 receptors

21
Q

What determines the anxiolytic action of diazepam?

A

alpha2-containing GABA-A receptors

22
Q

What is the difference in therapeutic delay for buspirone and Benzodiazepines?

A

Buspirone: 1-3 weeks
BZs: 15 min-2 hrs

23
Q

True/False? buspirone helps with panic attacks

A

False

24
Q

True/False? buspirone has hardly any side effects

A

True (slight sedation)

25
Q

Is Buspirone’s effect on 5-HT transmission predictable? Why (not)?

A

No.
- 5-HT1A receptors have opposing effects on 5-HT transmission (they inhibit 5-HT cell firing and release, but also mimic a postsynaptic action of 5-HT)

  • Partial agonists can have agonist-like or antagonist-like actions, depending on 5-HT tone
26
Q

What is the stereotypical beta blocker?

A

Propranolol

27
Q

What are the endogenous agonists at beta-adrinergic receptors? (2)

A

Noradrenaline and adrenaline

28
Q

Where are beta adrenergic receptors found?

A

Heart
Blood vessels in muscle
Bronchi
Brain

29
Q

What does the effect of beta blockade depend on?

A

sympathetic tone

30
Q

What are 5 unwanted effects of Propranolol?

A 
Bronchoconstriction in asthma 
Cardiac failure in heart disease 
Blocks signs of hypoglycemia in diabetic patients
Physical fatigue
Bad dreams
31
Q

True/False? Diazepam reduces somatic and psychic anxiety.

A

True

32
Q

True/False? Propranolol reduces somatic and psychic anxiety.

A

False, just somatic

33
Q

Which drugs work best for GAD?

A

Benzodiazepines ~ buspirone ~ SSRIs
Choice of drugs depends need of rapid onset and adverse effects

Beta blockers are widely used but not proven to work long term (considered second line)

34
Q

What are 2 examples of animal models?

A

Elevated plus maze

Fear-potentiated startle response

35
Q

True/False? Acute buspirone helped rats spend more time in the open arms of the elevated plus mase

A

False

36
Q

What is the fear-potentiated startle response?

A
  1. Pavlovian conditioning to associate light with shock
  2. startle in dark, measure response
  3. startle in light, measure response
  4. and 2. have different responses
37
Q

What are three advantages of the fear-potentiated startle response?

A
  • Detects broad range of anxiolytics
  • Not only order drugs, but newer ones (buspirone)
  • Reveals brain mechanisms
38
Q

True/False? Anxiety has many components

A

True

Phar 301 (23 decks)

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