Antianxiety Medications Flashcards
What are anti-anxiety medications also called?
- Sedative hyponotics
- Minor tranquilizers
What are among the most widely used drugs in medicine?
Benzodiazepines
What accounts for 75% of 100 million prescriptions written for sedatives/tranquilizers?
- diazepam (Valium) and
- chlordiazepoxide (Librium
What are the popular benzodiazepams?
- diazepam (Valium)
- lorazepam (Ativan)
- alprazolam (Xanax)
- midazolam (Versed) = “dazzle”
Are benzo’s addictive?
Yes - highly! Schedule IV/V opiates
What 3 effects do Benzodiazepines produce?
- Effects on behavior
- Anticonvulsant effects
- Muscle relaxation
What do Benzo’s do at low/high doses regarding behavior?
- Low - anxiety reduction
- High - drowsiness/depression
What two anticonvulsants can be used to prevent and arrest local anesthetic-induced seizures in dentistry?
V.V. = no seizure
- diazepam (Valium) - IV 5mg/min
- midazolam (Versed) - IV 1mg/min
Which Benzos are the most potent muscle relaxers?
- diazepam (Valium)
- chlordiazepoxide (Librium)
How do benzo’s cause muscle relaxation?
They depress the motor nerve and muscle function
What is the mechanism of action of BDZ’s?
- They enhance the inhibitory effect on GABA on neuronal excitability
- Remember GABA = inhibitory and decreases excitation on brain
- Causes hyperpolarization and neuronal stabilization
What are the binding characteristics of Benzodiazepines to their receptor sites?
- Rapid
- Reversible
- Stereospecific
- Saturable
How long are most benzo’s half lifes? And what are they metabolized into?
- Most have very long half-lives
- Most are metabolized to active compounds
What benzodiazepine is metabolized into inactive compounds, which makes it a great choice for dentistry?
lorazepam (Ativan)
What are the uses for benzos in medicine?
- Anxiety relief
- Skeletal muscle relaxation
- Hypnotic to treat insomnia
- Treatment of alcohol withdrawal
- Pre-operative medication
What are the uses of Benzo’s in dentistry?
- Reduce pre-operative anxiety
- Valium, Ativan, Xanax, Halcion
- IV sedative and amnesiac
- Emergency intervention for seizures
What are some adverse effects of benzodiazepines?
- CNS depression
- Xerostomia
- Abuse & addiction
- Additive effects with other CNS depressants, especially alcohol
What do you do when a benzodiazepine has to be given to a patient that is already taking opiates?
Reduce dose of opiates by 1/3 of normal dose
What is a very dangerous drug interaction of benzodiazepines?
Alcochol - results in severe CNS depression –> respiratory depression
The long half-life of benzo’s mean the risk persists for days after dose (20-50 hours)
What is a miscellaneous anti-anxiety agent?
buspirone (BuSpar)
What drugs do you avoid when taking BuSpar?
The red flag drugs:
- ciprofloxacin
- clarithromycin
- erythromycin
- doxycycline
- systemic antifungals
What drugs are known to cause xerostomia?
- Antidepressants & anti-anxiety meds
With what drugs do you have to be cautious with epinephrine?
Tricyclics & MAOIs
What’s known to cause bruxism?
SSRI’s
