antianxiety, relaxants, sedative hypnotics, etOH Flashcards
Alprazolam (Xanax)
Benzo
intermediate acting
anxiolytic
Chlordiazepoxide (Librium)
Benzo
long acting
Anxiolytic, Anticonvulsant, Withdrawal suppressant
Diazepam (Valium)
Benzo, Centrally acting musc. relaxant
long acting
Anxiolytic, Anticonvulsant, Anesthesia supplement,
Withdrawal suppressant, Muscle relaxant (for spasms)
Lorazepam (Ativan)
Benzo, Centrally acting musc. relaxant
intermediate acting
Hypnotic, Anxiolytic, Anesthesia supplement, Withdrawal suppressant
Midazolam (Versed)
Benzo
short-acting
Induction or supplement to anesthesia
Temazepam (Restoril)
Benzo
intermediate-acting
hypnotic
Triazolam (Halcion)
Benzo
short acting (good to help fall asleep)
hypnotic
Flumazenil (Romazicon)
BENZODIAZEPINE ANTAGONIST
antag. at benzo receptor
not v. useful in emergencies: benzos don’t depr. resp that much, won’t reverse barb/opiate/etOH induced resp depr.
- used in anesthesiology: post-op when given benzo, block effects, come out quicker
- can trigger seizures in pts dependent on benzos/barbs/etOH
Butalbital (Fiorinal)
BARBITURATE
for tension ha, centrally acting relaxant
Pentobarbital (Nembutal)
BARBITURATES
intermediate/short acting
sedative-hypnotics
Phenobarbital
BARBITURATES
long acting
tx for epilepsy, anticonvulsant
Thiopental (Pentothal)
BARBITURATES
ultra-short acting
not currently used
IV induction of sx anesthesia
used for execution, then pancuronium (NM blocker)–>then K to stop heart
Balcofen (Lioresal)
CENTRALLY ACTING MUSCLE RELAXANT
analog of GABA, acts as agonist at GABAb
dec. skel. musc tone
tx spasticity (UMN probs)
rehab medicine
adverse: CNS depression, musc. wkness, dependence/abuse potential
Cyclobenzaprine (Flexeril)
CENTRALLY ACTING MUSCLE RELAXANT
related to tricyclic antideps.
most widely prescribed muscle relaxant
doesn’t work as well as benzos
don’t operate machinery, drive
highly sedating
Diazepam (Valium)
CENTRALLY ACTING MUSCLE RELAXANT
muscle spasms
Metaxalone (Skelaxin)
CENTRALLY ACTING MUSCLE RELAXANT
Tizanidine (Zanaflex)
CENTRALLY ACTING MUSCLE RELAXANT
alpha2 agonist (like Clonidine) CNS effects: dec. skel musc. tone
very sedating (take at night)
Alcohol
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
anxiolytics, sedative, relaxant
Buspirone (Buspar)
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
anti-anxiety, NO musc. relaxation, NOT sedating
Gammahydroxybutyrate (GHB)
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
abused: party/club, date rape
GABA analog, crosses BBB
ergogenic effect: body building
Melatonin
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
nutritional suppl, not prescription, OTC
can normalize sleep patterns- “shift-work disorder”, travel
no effect on REM sleep (good quality sleep!)
don’t work well for most
Ramelteon (Rozerem)
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
melatonin-rec agonist
jet-leg, etc.
Zolpidem (Ambien)
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
longer acting (6-8 hrs)
widely presc. sleep med
newer, even less effect on REM sleep (good!)
non-benzos, but benzo agonist, bind receptors
enhance GABA-stim Cl- influx
less anxiolytic, less musc relaxant
should be prescribed short term
Zaleplon (Sonata)
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
short acting (2-4 hrs)
help getting to sleep initially
or take in middle of night
Oxazepam (Serax)
Benzo
intermediate-acting
sleep aid
Hypnotic, Anxiolytic
Disulfiram (Antibuse)
etOH tx
inhibits of aldehyde dehydrogenase : blocks conversion of acetaldehyde to acetate
“acetaldehyde sickness”
*induces unpleasant rxn: flushing, ha, nausea, confusion
encourages abstinence
hepatotoxicity
also inhibits p450, drug interactions
Acamprosate (Campral)
etOH tx
decrease cravings for alcohol
may involve glutamate and GABA receptors, block NMDA receptors, stimulate GABA-A rec.
less potential for hepatoxicity than others
can use combo with naltrexone
Naltrexone (ReVIA)
etOH tx
long-acting opioid antagonist
reduce craving for alcohol in alcoholic
hepatotoxicity can make pain worse
other form: vivitrol: repo injection
Eszopiclone (Lunesta)
MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC
longer acting (6-8 hrs)
act at benzo receptors (benzo agonist) but NOT benzos
action of these drugs
graded dose dep depression of CNS function
see graph
barbituate curve
steep curve, more potent than etOH
used to prescribe enough barb sleeping pills to kill someone