Anxiety and Insomnia

Question 1

The more lipid soluble the drug…

Answer 1

… the faster the onset and the shorter the duration of action

Question 2

PK of diazepam

Answer 2

200 h, active metabolite

Question 3

Therapeutic use of diazepam

Answer 3

anxiety
panic attacks
preanesthetic 
muscle relaxant
status epilepticus

Question 4

Difference between lorazepam and diazepam

Answer 4

lorazepam has a shorter half life

Question 5

Therapeutic use of lorazepam

Answer 5

anxiety, insomnia

Question 6

Benzodiazepines for anxiety

Answer 6

alprazolam, diazepam, lorazepam

Question 7

Benzodiazepines for insomnia

Answer 7

triazolam, flurazepam

Question 8

Benzos for epilepsy and seizures

Answer 8

diazepam and lorazepam

Question 9

Benzos for muscle relaxation

Answer 9

diazepam

Question 10

Benzos for withdrawl

Answer 10

lorazepam, sometimes diazepam

Question 11

CNS effects of benzos

Answer 11

decrease anxiety
hypnosis
muscle relaxation
anterograde amnesia
interfere with learning and memory
additive CNS depressant effects

Question 12

Cautions with benzos

Answer 12

caution in patient with sleep anpnea or chronic lung disease

Question 13

Metabolism of long acting benzos

Answer 13

phase 1 and 2, with active metabolites

Question 14

long acting benzos

Answer 14

diazepam and flurazepam

Question 15

Shorter acting benzos metabolized by phase 1 and phase 2

Answer 15

alprazolam, midazolam, triazolam

Question 16

Shorter acting benzos metabolized only by phase 2

Answer 16

lorazepam

Question 17

Adverse effects of benzos

Answer 17

drowsiness, sedation
impaired motor function
confusion, memory loss (elderly)
tolerance develops to side effects, not anti-anxiety effects

Question 18

Rare paradoxical reaction

Answer 18

rage reaction

Question 19

Contraindications of benzos

Answer 19

pregnancy

Question 20

withdrawl effects of benzos

Answer 20

anxiety (sometimes rebound), autonomic like signs

Question 21

benzodiazepine antagonist

Answer 21

flumazenil

Question 22

Therapeutic use of flumazenil

Answer 22

reverse sedative effect after anesthesia

reverse benzo overdose

Question 23

Therapeutic use of buspirone

Answer 23

generalized anxiety disorder

Question 24

MOA of buspirone

Answer 24

not clear

Question 25

Advantages of buspirone

Answer 25

no hypnosis
no rebound
minimum abuse
preg cat B

Question 26

Disadvantages of buspirone

Answer 26

only generalized anxiety

takes 1 to 2 weeks to produce effect