Anxiety and insomnia Flashcards
What are anxiolytics
Sedatives
What are the most common anxiolytics and hypnotics
Benzodiazepines
Name some anxiolytics and hypnotics
Hypnotics - Benzos, Z drugs, promethazine, melatonin, clomethiazole
Anxiolytics - Benzos, buspirone meprobamate, barbiturates
Why should anxiolytics and hypnotics be reserved for short term use only
Risk of dependence and difficulty in withdrawing the drug
Should you use benzos for mild anxiety
No - risk of dependence
How should you reduce benzos
Gradually, otherwise can lead to benzodiazepine withdrawal syndrome that can start anywhere up to 3 weeks later
Long term benzos withdrawal protocol
Transfer to equivalent daily dose of diazepam, preferably at night and reduce (1-2mg every 2 to 4 weeks)
How long does it take for the withdrawal symptoms of benzos to resolve
6 to 18 months
Side effects of benzos
Drowsiness and light-headedness the next day, confusion and ataxia
Overdose - drowsiness, ataxia, respiratory depression and coma
What can be used for panic attacks
IV diazepam
IV Lorazepam
What impairment must we watch out for
Hepatic- benzos are cleared hepatically so the drugs can precipitate coma. Avoid in severe hepatic impairment
What does alcohol do when using with benzos
Effect of benzos enhanced with alcohol use so more chances of developing dependence for benzodiazepines
Name some benzodiazepine withdrawal symptoms
Insomnia
Anxiety
Loss of appetite and weight
Tremor
Benzo reversible agent
Activated Charcoal
What should be done when treating paradoxical effects (increase in hostility, anxiety and aggression)
Adjust doses up or down
