Anxiolytics

Question 1

Diazepam (Valium) Increasing Dose Effects

Answer 1

Sedation –> Hypnosis –> Anestheia

Question 2

GABA-a1 receptor

Answer 2

Hypnotic/Anti-Convulsant Effects

Question 3

GABA-a2 receptor

Answer 3

Anxiolytic effects

No specific drug for only these receptors yet… Good potential

Question 4

GABA-a5 receptor

Answer 4

Mediates tolerance and dependency

Question 5

Anxiolytic Treatment

Answer 5

1. SSRI’s
2. Benzo’s
3. Buspirone

Question 6

Anxiolytic Benzo’s

Answer 6

Diazepam (Valium)
Alprazolam (Xanax)
Chlordiazepoxide
Clorazepate 
Clonazepam

Question 7

Short Acting Benzodiazepenes

Answer 7

ATOM:
Alprazolam
Triazolam
Oxazepam
Midazolam

Question 8

Not metabolized by the liver

Answer 8

Oxazepam, Tenazepam, Lorazepam

Outside The Liver

Question 9

Benzo’s MOA

Answer 9

Bind to allosteric site and increase the action of GABA

Increase the frequency of opening of the Chloride Channel via the GABA-A receptor

Question 10

Hypnotic Benzo’s

Answer 10

Triazolam
Estazolam
Tenazepam

Limit use to 4 weeks - risk of dependency and tolerance
Increase Stage 2 NREM sleep
Lest restful

Question 11

Procedural Sedation Benzo’s

Answer 11

Midazolam (Versed)

Lorazepam (Ativan)

Question 12

Reversal Agent for Benzo Overdose

Answer 12

Flumazenil - IV only

Question 13

Buspirone

Answer 13

Partial 5HT1A agonist
Effective as mono therapy or with SSRIs
Slower onset

Rarely used
No sedation, addiction, or tolerance. NO WITHDRAWAL
No interaction with alcohol

Question 14

Anti-Convulsants

Answer 14

Gabapentin, Pregabablin

Question 15

Hydroxyzine

Answer 15

H1 Antagonist

Separation Anxiety

Question 16

D-Cycloserine

Answer 16

Used for exposure therapy

Question 17

Non-Benzo Hypnotics

Answer 17

ZZZ - A1 receptor selective
Zolpidem - short acting
Zaleplon - short acting. Good for people with only intermittent sleep problems

esZopiclone - Lunesta, long term use

First line Hypnotics

Question 18

Ramelteon

Answer 18

MT1 and MT2 melatonin receptor agonists

Question 19

Suvorexant

Answer 19

Dural Orexin receptor ANTAGONIST

TX: Insomia

Question 20

Triazolam
Estazolam
Tenazepam

Answer 20

Hypnotic Benzo’s

Limit use to 4 weeks - risk of dependency and tolerance
Increase Stage 2 NREM sleep
Lest restful

Question 21

Alprazolam
Triazolam
Oxazepam
Midazolam

Answer 21

Short Acting Benzodiazepenes

ATOM
Higher addictive potential

Question 22

Diazepam 
Chlordiazepoxide
Alprazolam
Clorazepate 
Clonazepam

Answer 22

Anxiolytic Benzo’s

Diazepam = Valium
Alprazolam = Xanax

Question 23

Midazolam

Lorazepam

Answer 23

Procedural Sedation Benzo’s

Midazolam = Versed
Lorazepam = Ativan - Treatment for alcohol withdrawal

Question 24

OCD

Answer 24

TX: Clomipramine (TCA)

but* SSRI if breastfeeding

Question 25

Triazolam

Answer 25

Hypnotic Benzo

Question 26

Estazolam

Answer 26

Hypnotic Benzo

Question 27

Tenazepam

Answer 27

Hypnotic Benzo