Anxiety Flashcards
name all the benzodiazepines ?
alprazolam clobazam chlordiazepoxide diazepam lorazepam oxazepam
Shorter acting benzodiazepines ?
lorazepam, oxazepam
5HT1a agonist ?
buspirone
how long does buspirone take to work ?
takes two weeks to work. low potential for abuse and dependence
When would short acting benzodiazepines would be preferred over long acting ?
in elderly, liver impairment. However, carries greater risk of withdrawal symptoms.
How does benzodiazepines work ?
facilitates and enhances the binding of GABA to the GABAa receptor to cause widespread depressant effect on synaptic neurotransmission.
Benzodiazepines clinical manifestations ?
anxiolysis, sedation, muscle relaxation and anticonvulsant effects
Benzodiazepines side effects ?
paradoxical increase in hostility aggression
sedation
Signs and symptoms of benzodiazepines overdose ?
ataxia, drowsiness, dysarhtria, nystagmus and occasionally respiratory depression and coma
What are the benzodiazepine withdrawal syndrome symptoms ?
increased anxiety, insomnia, weight loss, tremors, sweating, loss of appetite, perceptual disorders, tinnitus
How long after withdrawal symptoms occurs with short acting and long acting benzodiazepines ?
Short : occurs within a day
Long: within 3 weeks of stopping
How to withdraw benzodiazepines ?
- Gradually convert ( over one week ) to equivalent diazepam dose ON.
- Reduce diazepam dose by 1-2mg increments every two to four weeks
- Reduce diazepam dose further: can reduce in smaller steps of 500 mcg towards the end
Which drugs would cause benzodiazepines concentration to increase ?
Amiodarone, diltiazem, macrolides, fluconazole,
Which drugs would lead to increased sedation and CNS depressant effects when given with benzodiazepines?
Alcohol, antihistamines, opioids, antidepressants, barbiturates, antipsychotics, Z-drugs
