Anti-Anxiety/Sedation

Question 1

Alprazolam [Xanax]

Answer 1

BNZ w/ intermediate onset, t1/2, duration
Use: anxiety, panic attacks
PK: not to nordiazepam -> rapid renal elim, depend on CYPs
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 2

Chlordiazepoxide [Librium]

Answer 2

BNZ w/ intermediate onset, long duration and t1/2
Use: alcohol w/draw
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 3

Clonazepam [Klonopin]

Answer 3

BNZ w/ intermediate onset, short duration and t1/2
Use: anxiety
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 4

Clorazepate [Tranxene]

Answer 4

BNZ w/ rapid onset, long duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 5

Lorazepam [Ativan]

Answer 5

BNZ w/ intermediate onset, t1/2, duration as IV admin
Use: anxiety, +/- alcohol w/draw
PK: not to nordiazepam -> rapid renal elim, direct glucuronidaiton, NO CYPs
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
Withdraw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 6

Oxazepam [Serax]

Answer 6

BNZ w/ slow onset, short duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 7

Prazepam [Centrax]

Answer 7

BNZ w/ slow onset, long duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 8

Buspirone [BuSpar]

Answer 8

Non-BNZ anti-anxiety, as effective but takes longer
Suppress 5HT and Enhance NE/D (really ?)
NO anti-convulsant, muscle relax, or sedative effects (only anti-anxiety)

Question 9

Propranolol [Inderal]

Answer 9

Beta-Blocker for stage fright/performance anxiety
Dec somatic/autonomic symptoms of anxiety
No CNS alterations on emotion

Question 10

Flumanezil [Romazicon]

Answer 10

BNZ Antagonist

Use: BNZ OD

Question 11

Diazepam [Valium]

Answer 11

BNZ w/ rapid onset, long duration and t1/2
Use: muscle relax, alcohol w/draw
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 12

Triazolam [Halcion]

Answer 12

BNZ w/ rapid onset, short duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions

Question 13

Flurazepam [Dalmane]

Answer 13

BNZ w/ rapid onset, long duration and t1/2
PK: through nordiazepam -> slow metabolism, CYPs dependent
ADE: sedation (resp depres/contra other sedatives), Cat D, tolerance/dependence
W/draw: w/ abrupt discontinue and short-acting, autonomic SNS, rebound anxiety/insomnia, convulsions