Anxiolytics

Question 1

1st line treatment

Answer 1

psychological intervention

Question 2

1st line pharmacological - SSRI antidepressants

slow onset

Answer 2

sertraline
citalopram
fluoxetine

SNRI: venlafaxine

Question 3

benzodiazepine (for acute symptoms, in short term –> dependence –> change in GABA alpha2 subunit)

FAST ONSET

Answer 3

nitrazepam, diazepam

inc affinity of GABA to GABA A receptor (inc frequency, not duration)

side effects: drowsiness, confusion, amnesia, dec motor coordination, dec depth of perception, dec REM sleep

Question 4

short half life benzos

Answer 4

zolpidem, lorprazolam - hypnotic, not used as anxiolytic

Question 5

mid half life benzo

Answer 5

nitrazepam - hypnotic and anxiolytic

Question 6

long half life benzo

Answer 6

diazepam- anxiolytic and anticonvulsant

Question 7

flumazenil

Answer 7

benzodiazepine antagonist

Question 8

barbiturates (less safe than benzos –> resp depression)

Answer 8

phenobarbtione

potentiate GABA (inc duration), inhibit AMPA

Question 9

5HT1A agonist - slow onset, GAD, short term, may initially inc anxiety

Answer 9

buspirone

partial agonist, less severe motor probs and sedation (safer than benzo)

Question 10

reduce peripheral symptoms of anxiety

Answer 10

propranolol

Question 11

antipsychotics

Answer 11

rarely used

Question 12

HYPNOTICS: antihistamines (H1 antagonist)

Answer 12

diphenhydramine, promethazine

drowsiness, hangover effect

Question 13

HYPNOTICS: melatonin agonists (elderly or autistic patients)

Answer 13

ramelteon, agomelatin

Question 14

anxiolytics (3)

Answer 14

SSRI, buspirone, propranolol

Question 15

sedative

Answer 15

pre anaesthetics

Question 16

hypnotics

Answer 16

antiH, chloral hydrate, sodium oxybate

Question 17

anxiolytics, sedatives, and hypnotics

Answer 17

benzodiazepines, zopiclone, barbiturates