Antianxiety flash Flashcards
What are the benzodiazepines?
Antianxiety drugs “pams and lams”
What are the benzodiazepines primarily used to treat anxiety - longer duration?
Chlordiazepoxide, diazepam, alprazolam, clonazepam, clorazepate, oxazepam, lorazepam.
What are the benzodiazepines primarily used to treat insomnia? shorter duration
Flurazepam, temazepam, estazolam, quazepam, triazolam
Which benzodiazepine is used in surgery?
Midazolam
What is the mechanism of action of benzodiazepines?
Can increase GABAergic neuron activity - bind to GABA receptor and make it more sensitive to GABA (limited by amount of GABA available)
What is the therapeutic index of benzodiazepines?
Very high
What is flumazenil?
Benzodiazepine receptor blocker (BEN is off with the FLU)
How is flumazenil administered?
I.V. (1st pass effect)
What are the non benzodiazepine hypnotics used for?
Only for sleep
What are the non benzodiazepine hypnotics?
Z drugs zolpidem, zaleplon, eszopiclone.meprobamate, ramelteon, buspirone.
What is the mechanism of action of non benzodiazepine hypnotics?
Act on benzodiazepine receptors at a different site than benzodiazepines
What is a concern with meprobamate?
(OBAMA) strong interaction with ethanol which can often lead to accidental suicide
What is the mechanism of action of ramelteon?
raMELteon - Melatonin receptor agonist. Reduces time to onset of sleep by several minutes
What is the mechanism of action of buspirone?
Partial serotonin receptor agonist
What is buspirone primarily used for?
Antianxiety - not sedative or hypnotic
What are the barbiturates?
The “itals” antianxiety/sedation/hypnotic (do it all)
What are some of the barbiturates?
Pentobarbital/secobarbital (3-4 hours of duration), butabarbital/amobarbital (6-8 hours of duration), mephobarbital/*phenobarbital (10-16 hours of duration)
What is the mechanism of action of the barbiturates?
Enhance GABA effect - efficacy»_space; the benzodiazepines
What are some problems associated with barbiturates?
Depressed respiration - used in suicide attempts, induces p450, suppression of REM sleep leading to REM rebound
What is chloral hydrate?
Knockout drops good for inducing but not maintaining sleep
What are antihistamines that are good for inducing sleep?
Diphenhydramine and hydroxyzine
