Anxiety

Question 1

Give examples of anxiolytic drugs

Answer 1

Benzo

Beta blockers
- Propanolol
- Oxprenolol

5-HT agonist
- Buspirone (RED abuse + dependence)

Antidepressants
- Escitalopram
- Paroxetine
- Duloxetine
- Trazadone

Antiepileptic
- Pregablin

Antipsychotic
- Prochlorperazine

Question 2

Benzodiazepines - clobazam

Answer 2

adjunct in epilepsy

Question 3

Benzodiazepines - Chlordiazepoxide

Answer 3

adjunct in acute alcohol w/drawal

Question 4

Benzodiazepines - diazepam

Answer 4

insomnia, dental, IV = thrombophlebitis

Question 5

Benzodiazepines - lorazepam

Answer 5

insomnia, dental - Short acting: elderly + liver impairment

Question 6

Benzodiazepines - oxazepam

Answer 6

insomnia - Short acting: elderly + liver impairment

Question 7

What is the MOA of benzodiazepines?

Answer 7

Enhance binding of GABA at GABA receptors = CNS depressant effect

Question 8

What are the indications for benzodiazepines?

Answer 8

Anxiety (short term)
- AVOID in elderly (half dose) + liver impairment - use short acting if essential

Muscle spasms

Seizures

Insomnia

Question 9

What are the side effects of benzodiazpines?

Answer 9

Sedation
- Label: warning: this medicine makes you sleepy, if you still feel sleepy the next day, do not drive or use tools or machines. Do not drink alcohol

Ataxia, muscle weakness
- Caution: myasthenia gravis

Paradoxical effect (INC anxiety, hostility + aggression)

Respiratory depression
- Caution: respiratory disease (asthma)
- MHRA: Benzodiazepines + opioids: additive CNS depressant effect

Dependence + tolerance
- Caution: avoid prolonged use + abrupt w/drawal, substance misuse + some personality disorders