Anxiolytics Flashcards
Can BZDPNS be used as sole treatment for chronic anxiety?
No they should not
Are BZDPNs appropriate for treating depression or chronic psychosis
No
Are BZDPNs appropriate for stress related symptoms, unhappiness or minor physical disease
no
in bereavement, what effect can BZDPNs have on psychological adjustment have
In bereavement, psychological adjustment may be inhibited by benzodiazepines.
Dependence on BZDPNs is particularly likely in pt with … (3)
history of alcohol or drug abuse and in patients with marked personality disorders.
What type of symptoms do beta-adrenoceptor blocking drugs e.g. BB reduce?
autonomic e.g. tremor, palpitation
Do beta-adrenoceptor blocking drugs affect psychological symptoms of anxiety (e.g. worry, tension, fear) or non-autonomic symptoms (e.g. muscle tension)
No they do not reduce these.
BB are indicated for pt with predominantly …. symptoms
somatic e.g. tremor, palpitations
this may in turn prevent onset of worry and fear
what type of anxiety are BZDPNs indicated for
short-term relief of severe anxiety
avoid long term use
BZDPNs are indicated for short term relief of severe anxiety. what type of BZDPNs may be preferred in patients with HI?
shorter acting compounds
but they carry greater risk of withdrawal symptoms
LOLA
Liver: oxazepam, lorazepam, alprozolam (anxiolytic SA BZDPNS)
In panic disorders (with or without agoraphobia) resistant to antidepressant therapy what can you use
benzodiazepine may be used; alternatively, a benzodiazepine may be used as short-term adjunctive therapy at the start of antidepressant treatment to prevent the initial worsening of symptoms.
The following 2 BZDPNs are occasionally administered IV for control of panic attacks
Diazepam or lorazepam
This route is the most rapid but the procedure is not without risk and should be used only when alternative measures have failed
does IM route have advantage over oral route for administration of BZDPNs
no
Buspirone is thought to act at ….
specific serotonin receptors
buspirone contraindicated in which disorder
epilepsy
what is buspirone indicated for
Anxiety (short-term use)
Reduce dose of buspirone to 2.5 with potent inhibitors e.g.
clarithromycin, ketoconazole, itraconazole
these increase exposure to buspirone adjust dose.
what is buspirone in terms of CYP??
its a subsrate and is affected by POTENT inhibitors and inducers e.g.
inhibitors: clarith, keto, itraconazole increase exposure so adjust buspirone dose to max 2.5mg daily
inducers: carb, phenytoin etc they reduce exposure
response to treatment with buspirone may take up to ..
2 weeks
does buspirone alleviate the symptoms of BZDPN withdrawal
no
Buspirone does not alleviate the symptoms of BZDPN withdrawal. therefore what should you do about BZDPN when a pt it to take buspirone
pt taking BZDPN will still need to have it withdrawn gradually, usually advisable to do this BEFORE starting buspirone.
dependence and abuse potential of buspirone
low
this drug is not recommended - it is less effective than the benzodiazepines, more hazardous in overdosage, and can also induce dependence.
Meprobamate
which acting barbiturates have place only in the treatment of severe intractable insomnia in patients already taking barbiturates
intermediate acting
avoid intermediate-acting barbiturates in …
elderly
this is a very short acting barbiturate that is used in anaesthesia
thiopental sodium
thiopental sodium - use
very short-acting barbiturate used in anaesthesia
Increased hostility and aggression after barbiturates and alcohol usually indicates ….
intoxication
the following symptoms after barbiturates and alcohol usually indicates intoxication.
Increased hostility and aggression
