Anxiolytics

Question 1

Can BZDPNS be used as sole treatment for chronic anxiety?

Answer 1

No they should not

Question 2

Are BZDPNs appropriate for treating depression or chronic psychosis

Answer 2

No

Question 3

Are BZDPNs appropriate for stress related symptoms, unhappiness or minor physical disease

Answer 3

no

Question 4

in bereavement, what effect can BZDPNs have on psychological adjustment have

Answer 4

In bereavement, psychological adjustment may be inhibited by benzodiazepines.

Question 5

Dependence on BZDPNs is particularly likely in pt with … (3)

Answer 5

history of alcohol or drug abuse and in patients with marked personality disorders.

Question 6

What type of symptoms do beta-adrenoceptor blocking drugs e.g. BB reduce?

Answer 6

autonomic e.g. tremor, palpitation

Question 7

Do beta-adrenoceptor blocking drugs affect psychological symptoms of anxiety (e.g. worry, tension, fear) or non-autonomic symptoms (e.g. muscle tension)

Answer 7

No they do not reduce these.

Question 8

BB are indicated for pt with predominantly …. symptoms

Answer 8

somatic e.g. tremor, palpitations
this may in turn prevent onset of worry and fear

Question 9

what type of anxiety are BZDPNs indicated for

Answer 9

short-term relief of severe anxiety
avoid long term use

Question 10

BZDPNs are indicated for short term relief of severe anxiety. what type of BZDPNs may be preferred in patients with HI?

Answer 10

shorter acting compounds
but they carry greater risk of withdrawal symptoms

LOLA
Liver: oxazepam, lorazepam, alprozolam (anxiolytic SA BZDPNS)

Question 11

In panic disorders (with or without agoraphobia) resistant to antidepressant therapy what can you use

Answer 11

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.

Question 12

The following 2 BZDPNs are occasionally administered IV for control of panic attacks

Answer 12

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

Question 13

does IM route have advantage over oral route for administration of BZDPNs

Answer 13

no

Question 14

Buspirone is thought to act at ….

Answer 14

specific serotonin receptors

Question 15

buspirone contraindicated in which disorder

Answer 15

epilepsy

Question 16

what is buspirone indicated for

Answer 16

Anxiety (short-term use)

Question 17

Reduce dose of buspirone to 2.5 with potent inhibitors e.g.

Answer 17

clarithromycin, ketoconazole, itraconazole

these increase exposure to buspirone adjust dose.

Question 18

what is buspirone in terms of CYP??

its a subsrate and is affected by POTENT inhibitors and inducers e.g.

Answer 18

inhibitors: clarith, keto, itraconazole increase exposure so adjust buspirone dose to max 2.5mg daily

inducers: carb, phenytoin etc they reduce exposure

Question 19

response to treatment with buspirone may take up to ..

Answer 19

2 weeks

Question 20

does buspirone alleviate the symptoms of BZDPN withdrawal

Answer 20

no

Question 21

Buspirone does not alleviate the symptoms of BZDPN withdrawal. therefore what should you do about BZDPN when a pt it to take buspirone

Answer 21

pt taking BZDPN will still need to have it withdrawn gradually, usually advisable to do this BEFORE starting buspirone.

Question 22

dependence and abuse potential of buspirone

Answer 22

low

Question 23

this drug is not recommended - it is less effective than the benzodiazepines, more hazardous in overdosage, and can also induce dependence.

Answer 23

Meprobamate

Question 24

which acting barbiturates have place only in the treatment of severe intractable insomnia in patients already taking barbiturates

Answer 24

intermediate acting

Question 25

avoid intermediate-acting barbiturates in …

Answer 25

elderly

Question 26

this is a very short acting barbiturate that is used in anaesthesia

Answer 26

thiopental sodium

Question 27

thiopental sodium - use

Answer 27

very short-acting barbiturate used in anaesthesia

Question 28

Increased hostility and aggression after barbiturates and alcohol usually indicates ….

Answer 28

intoxication

Question 29

the following symptoms after barbiturates and alcohol usually indicates intoxication.

Answer 29

Increased hostility and aggression