Anxiolytics Flashcards

1
Q

Name three benzodiazepines with active metabolites up to 100 hours after dosing.

A

Diazepam, Chlordiazepoxide, Flurazepam

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2
Q

What is Midazolam (Versed) used for?

A

Anesthesia

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3
Q

What is it about Benzos vs. Barbs that causes significant reduction in overdose deaths?

A

Benzos have a ceiling effect. They do not directly open Cl- channels like Barbs due at high doses. Benzos can only augment binding of GABA to GABA receptors.

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4
Q

Name 6 benzodiazepines used as a short term depression, maintenance bipolar, and severe bipolar treatments

A

Diazepam, Lorazepam, Chlordiazepoxide, Flurazepam, Alprazolam, and Triazolam

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5
Q

Name two of the benzodiazepines used to cause sedation?

A

Lorazepam (Ativan) and Alprazolam (Xanax)

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6
Q

In addition to the treatment of bipolar and depression, what can Diazepam by used as?

A

Anticonvulsant and muscle relaxant

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7
Q

Which sedative-hypnotics can be used to induce sleep?

A

Triazolam and zolpidem

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8
Q

Lorazepam can limit withdrawal from what?

A

Alcohol

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9
Q

MOA of benzos?

A

GABAa agonist, bind between alpha 1 and gamma 2 subunits

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10
Q

SE of benzos and barbs?

A

Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS w/ other drugs, pyschologic and physiologic dependence.

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11
Q

What is the difference between a sedative and hypnotic?

A
sedative= calming
Hypnotic= induce sleep, more pronounced CNS depression than sedation
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12
Q

Name the six overall uses of sedative-hypnotics.

A

Anxiety disorder, induce sleep, anesthesia, anticonvulsants, muscle relaxation, recreation

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13
Q

What GABAa receptor subtypes do benzos bind to?

A

BOTH BDZ1 (omega1) and BDZ2 (omega 2)

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14
Q

What are BDZ1 selective agonists?

A

sleeping pills

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15
Q

Name a BDZ-1 selective agonist.

A

Zolpidem

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16
Q

SE of Zolpidem?

A

sleeping walking; next morning impairment

17
Q

From low dose to high dose what effects do benzos have?

A

Sedation, hypnosis, muscle relaxation, anticonvulsant activity

18
Q

What can be used to treat benzo overdose?

A

Flumazenil

19
Q

MOA of flumazenil?

A

competitive non-selective antagonist

20
Q

SE of flumazenil?

A

withdrawal (potentially life threatening)

Seizures in mixed overdoses

21
Q

MOA of thiopental?

A
GABAa agonist (binds a or B subunit)
highly lipid soluble, fast on, fast off
22
Q

Thiopental use?

A

Induce anesthesia

23
Q

Phenobarbitol use?

A

anti-epileptic, anti-convulsant

24
Q

What class of drugs do Phenobarbitol and thiopental belong to?

A

Barbiturates

25
Q

MOA of phenobarbital?

A

GABAa agonist (binds a or b subunit)

26
Q

What is the risk of stopping barbiturates/ alcohol immediately?

A

abrupt withdrawal is life threatening

27
Q

What is buspirone used as?

A

anxiolytic w/o sedation

28
Q

MOA of buspirone?

A

No GABAa interaction, may be 5HT1A agonist

29
Q

What sedative hypnotics are used for anesthesia?

A

Thiopental- induction

Midazolam- calming and produce anterograde amnesia

30
Q

Name three sedative hypnotics used as anticonvulsants?

A

lorazepam, diazepam, phenobarbital