Anxiolytics

Question 1

What Class is BENZOS? antidote?

Answer 1

C4

Flumazenil

Question 2

Therapeutic index for Benzos?

Answer 2

High

Question 3

How do benzos work?

Answer 3

potentiate GABAminergic stimulation

Question 4

Benzos and seizures?

Answer 4

increase seizure threshold

Question 5

Clinical uses for benzos?

Answer 5

• Seizures
• Anxiety
• Antiemetic
• Anesthetic induction
• Alcohol withdrawal
• Muscle relaxation
• Insomnia

Question 6

Side effects of Benzos?

Answer 6

• Drowsiness
• Confusion
• Sluggishness
• Retrograde amnesia

Question 7

When is benzo toxic?

Answer 7

if mixed with another CNS depressant

Question 8

What Benzo has shortest T1/2?

Answer 8

Lorazepam, dosed in 0.1

Question 9

Best benzo for hepatic disease?

Answer 9

Lorazepam (no active metabolites)

Question 10

A/E of Lorazepam?

Answer 10

RD & confusion

Question 11

What other benzo has a short T1/2

Answer 11

Oxazepam, dosed in 10, 15, 30mg

Question 12

What is a calming herbal?

Answer 12

Valarian

Question 13

What benzo has a moderate T1/2?

Answer 13

Alprazolam (Xanax) good for panic attacks

Question 14

What benzo has a long T1/2?

Answer 14

Diazepam (valium), not ideal in elderly

Its metabolites are Lorazepam & Oxazepam

Question 15

What benzo is good for insomnia?

Answer 15

Temazepam

Question 16

What is the nonbenzo anxiolytic? How does it work?

Answer 16

Buspirone

Serotonin antagonist

Question 17

Benefits of Buspirone?

Answer 17

No sedation, buzz, street value, not a controlled substance

Good for bus drivers

Question 18

Why give Buspirone to drug seekers?

Answer 18

Takes 2-3 weeks to kick in

Question 19

What are the non-benzo benzos? CLASS?

Answer 19

• Zolipidem (Ambien)
• Zaleplon (Sonata)
• Eszopiclone (Lunesta)

C4

Question 20

First line for insomnia?

Answer 20

Benadryl

Question 21

Zolipidem indicated for what?

Answer 21

Short term insomnia, no longer than 7-10 days

Good for sleep walking behavior

Question 22

Zolipidem has little effects on what?

Answer 22

Skeletal muscle & seizure threshold

Question 23

Zaleplon half life?

Answer 23

Shorter than zolipdem

rapid onset

Question 24

Zaleplon for what?

Answer 24

Mid-night awakenings

Question 25

What is indicated for chronic insomnia?

Answer 25

Eszopiclone

Question 26

What do you give drug seeking patients for insomnia? What is it?

Answer 26

Ramelteon, a melatonin receptor agonist with NO affinity for GABA and low abuse potential

Not scheduled

Question 27

How does Ramelteon work?

Answer 27

mimics normal sleep cycles, resets circadian rhythm

Question 28

Why drug interactions with Ramelteon?

Answer 28

CYP metabolism (CP450)

Question 29

What is the newest med for insomnia? Class?

Answer 29

Suvorexant, selevtive orexin receptor antagonist

C4

Question 30

What are orexins?

Answer 30

Keep people awake in sleep-wake cycle

Question 31

What are orexin disorders?

Answer 31

NARCOLEPSY

Question 32

When should you take suvorexant?

Answer 32

7 hours until wake time

Question 33

Who should not take suvorexant?

Answer 33

hepatic impairment or strong CYP inhibitors

Question 34

What is side effect of suvorexant?

Answer 34

sleep walking, especially when combined with ethanol

Question 35

What class is Chloral hydrate? What is it?

Answer 35

C3 potent sedative and hypnotic, inhibits alcohol dehydrogenase.