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Pharmacology Sem 3 > Anxiolytics > Flashcards

Anxiolytics Flashcards

1
Q

Neurtransmitters in Anxiety

A

LOW GABA (Gamma-aminobutyric acid); Low Serotonin; High Norepinephrine

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2
Q

If pt Low GABA, use what and why?

A

Benzodiazepine because it increases the attraction of the GABAa receptors to GABA; “Nurse please give Mr. Gabalow Ativan 2mg IM STAT”

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3
Q

Ativan, Xanax, Valium depress what?

A

depress CNS

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4
Q

Benzodiazipine facts

A

CNS depression, can’t really OD on it; additive effect with ETOH; pt can have increased tolerance and cross tolerance; cross tolerance is if pt tolerance to Xanax, also tolerance to Ativan, so Ativan may be ineffective to give.

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5
Q

Benzodiazipine W/D s/s (short term use)

A

agitation, insomnia, tremors, mm cramping, sweating, anorexia, tremor, nervousness

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6
Q

Benzodiazipine Geriatric Considerations

A

Paradoxical reaction; more agitated, talkative, anger and rage; So more Ativan = more agitation (not desired effect); can’t restraint d/t unsafe, DVT or decub

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7
Q

List two noradrenergic agents

A

Inderal (propanolol), Catapress (clonidine); noradrenergic agents inhibit physiological feedback

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8
Q

Use of Inderal propanolol

A

social anxiety; this is a non selective BB; decreases HR and BP; so more relaxed

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9
Q

Use of Clonidine Catapres

A

to decrease BP; when anxious norepinephrine go up, vessel constrict via alpha-adrenergic receptor, BP go up; alpha adrenergic receptors are targeted by both catecholamines (norepi and epi)

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10
Q

Benzodiazipine caution with what herbs?

A

Kava kava should not be combined with benzodiazipine because of increased sedative affect.

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11
Q

Anxiolytics are used to treat what?

A

anxiety and insomnia.

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12
Q

Name a major anxiolytic group?

A

Benzodiazepine. It’s a minor tranquilizer group.

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13
Q

Do benzodiazipine cause tolerance?

A

Yes. Tolerance within weeks and months

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14
Q

Difference between primary and secondary anxiety?

A

primary not caused by medical condition or drug. Secondary is.

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15
Q

Action of anxiolytics resembles

A

sedative-hypnotic effect (i.e. calm-sleep effect)

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16
Q

Before giving anxiolytic, tx by

A

nonpharma measures: relaxation, psychotherapy, support groups.

17
Q

Other uses of Benzodiazipine besides sever prolonged anxiety

A

anticonvulsant, sedative-hypnotic, preoperative drug

18
Q

How bezondiazipine is absorbed

A

lipid soluble and rapidly absorbed in GI tract

19
Q

Examples of Benzodiazipines

A

chlordiazepoxide librium, diazepam valium, clorazepate dipotassium tranxene, lorazepam ativan, and alprazolam xanax

20
Q

What the most popular benzodiazipine?

A

Ativan lorazepam

21
Q

How long to is benzodiazipine present in urine?

A

weeks or months after pt stopped taking

22
Q

How long should benzodiazipine be prescribed?

A

3 to 4 months

23
Q

Buspirone Buspar anxiolytic contrainidicated with

A

grapefruit juice. Leads to toxicity. Limit grapefruit juice to cup/day or half grapefruit.

24
Q

S/E of benzodiazipines

A

sedation, dizzy, HA, dry mouth, blurred vision, rare urinary incontinence, constipation,

25
Q

A/E of benzodiazipines

A

leukopenia (decreased WBC); so s/s fever, malaise, sore throat, tolerance, dependency

26
Q

Abrupt discontinuation of benzodiazipine causes

A

w/d sypmtoms onset 2-10 days, duration several weeks

27
Q

If pt OD on benzodiazipine

A

give antiemetic, follow with activated charcoal if pt conscious. If pt not conscious, do gastric lavage. Give benzodiazipine atangonist flumazenil romazicon IV if needed. Maintain airway, give O2 for low RR, monitor VS. Give vasopressor IV for severe low BP. Request mental health consult.

28
Q

What is antidote for benzodiazipine?

A

flumazenil Romazicon IV

29
Q

Benzodiazipine W/D s/s (long term/high dose use)

A

paranoia, delirium, panic, HTN, status epilepticus.

30
Q

How to prevent convulsions during w/d

A

give anticonvulsant

31
Q

Substances contraindicated with benzodiazipine

A

ETOH and CNS depressants. Leads to RR depression

32
Q

Substances that decrease effect of benzodiazipine

A

tobacco, caffeine, sympathomemetics

33
Q

Who should not take benzodiazipine?

A

the fetus; it’s teratogenic

34
Q

Noradrenergic agents are affected by what hormone?

A

norepinephrine

Pharmacology Sem 3 (26 decks)

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