Anxiolytics Flashcards
How do beta-blockers act?
eg: propranolol
reduces autonomic nervous system activation. reducing autonomic Sx like tachycardia, palpitations and tremor
Where might BB be contraindicated?
asthma
COPD
bronchospasm
heart clock
acute LVF
What is the most important thing to consider with Benzodiazepines?
causes dependency and withdrawal effects and misuse, so avoid first-line and long term
*no more than 6w: make it clear at start only short term!!
How do Benzos act?
bind to GABA to potentiate effects and reduce excitability of neurones
*positive allosteric modulators of GABA receptors
What are the indications for benzodiazepine?
insomnia
anxiety disorders
delirium
alcohol detox
acute psychosis
violent behaviour
What are some side effects of Benzos?
drowsy and lightheaded
confusion and ataxia
muscle weakness
etc
Why is benzo dangerous in overdose?
What can you give in this case?
ataxia
dysarthria
nystagmus
coma
resp depression
*A-E and IV flumazenil
How to identify Benzo withdrawal?
insomnia
anxiety
los of appetite
tremor
muscle twitching
sweating
tinnitus
perceptual disturbances
seizures
How does pregabalin work in reducing anxiety?
binds to voltage gated calcium channels on neurones, increasing threshold potential, CNS depressant
inhibits glutamate, noradrenaline and substance P
What are some indications for pregabalin?
anxiety
neuropathic pain
epilepsy
What are some side effects of pregabalin?
dizzy and drowsy
blurred vision
vivid dreams
weight gain
What is the role of antidepressants in anxiety treatment?
SSRI - useful in OCD (higher dose), unlike BZD optimal effectiveness delays so not addictive, long term!!
*most common and generally effective!
What are some hypnotics to know about?
BZD: temazepam
low dose amitriptyline
Z drugs like Zopiclone, Zolpidem *more favoured
*use for 2 weeks and only 5/7 days each week to reduce tolerance
