Anxiety and Insomnia Flashcards
The more lipid soluble the drug…
… the faster the onset and the shorter the duration of action
PK of diazepam
200 h, active metabolite
Therapeutic use of diazepam
anxiety panic attacks preanesthetic muscle relaxant status epilepticus
Difference between lorazepam and diazepam
lorazepam has a shorter half life
Therapeutic use of lorazepam
anxiety, insomnia
Benzodiazepines for anxiety
alprazolam, diazepam, lorazepam
Benzodiazepines for insomnia
triazolam, flurazepam
Benzos for epilepsy and seizures
diazepam and lorazepam
Benzos for muscle relaxation
diazepam
Benzos for withdrawl
lorazepam, sometimes diazepam
CNS effects of benzos
decrease anxiety hypnosis muscle relaxation anterograde amnesia interfere with learning and memory additive CNS depressant effects
Cautions with benzos
caution in patient with sleep anpnea or chronic lung disease
Metabolism of long acting benzos
phase 1 and 2, with active metabolites
long acting benzos
diazepam and flurazepam
Shorter acting benzos metabolized by phase 1 and phase 2
alprazolam, midazolam, triazolam
Shorter acting benzos metabolized only by phase 2
lorazepam
Adverse effects of benzos
drowsiness, sedation
impaired motor function
confusion, memory loss (elderly)
tolerance develops to side effects, not anti-anxiety effects
Rare paradoxical reaction
rage reaction
Contraindications of benzos
pregnancy
withdrawl effects of benzos
anxiety (sometimes rebound), autonomic like signs
benzodiazepine antagonist
flumazenil
Therapeutic use of flumazenil
reverse sedative effect after anesthesia
reverse benzo overdose
Therapeutic use of buspirone
generalized anxiety disorder
MOA of buspirone
not clear
Advantages of buspirone
no hypnosis
no rebound
minimum abuse
preg cat B
Disadvantages of buspirone
only generalized anxiety
takes 1 to 2 weeks to produce effect
