anxiolytics

Question 1

what is the therapeutic rationale for anxiety disorders

Answer 1

sedation
hypnoses
anxiolytic

Question 2

what is the dose dependent effects of anxiolytics

Answer 2

low dose: anxiolytic and sedative
higher doses: hypnotic
even higher: anaesthesia, used for surgery

Question 3

what are some classes of anxiolytics (2)

Answer 3

benzodiazepines, non Benzos

Question 4

what are some Benzos

Answer 4

diazepam, lorazepam, triazolam, temazepam, midazolam

Question 5

which benzos are used as anxiolytics and sedatives (2)

Answer 5

diazepam, lorazepam

Question 6

which benzos are used as hypnotics

Answer 6

diazepam, triazolam, temazepam

Question 7

which benzos are used as pre-anaesthetics

Answer 7

diazepam, midazolam

Question 8

which benzos may have anti convulsant effects

Answer 8

diazepam

Question 9

what are some examples of non benzos

Answer 9

barbiturates (phenobarbital)
buspirone
zolpidem
propanolol

Question 10

benzo MOA

Answer 10

GABA-inhibitory transmitter in brain region –> open more easily
potentiate influx of Cl- ions leading to hyper polarisation –> neutrons not firing
limbic system: alter mood
reticular activating system: cause drowsiness
motor cortex: relax muscles

Question 11

ADR of benzos

Answer 11

OD (severe respiratory depression esp with use with alcohol)
drowsiness confusion amnesia
impaired muscle coordination
tolerance and dependence

Question 12

how is benzo OD treated

Answer 12

flumazenil (benzo antagonist)

Question 13

what is zolpidem

Answer 13

potentiates GABA mediated Cl- currents at the same site as benzos
good hypnotic effect

Question 14

what is zolpidem primarily used to treat

Answer 14

insomnia

Question 15

disadvantage of zolpidem

Answer 15

not effective as anxiolytic

Question 16

what is buspirone

Answer 16

serotonin 5HT1a receptor partial agonist
also binds to dopamine receptors
indicated for GAD

Question 17

disadvantage of buspirone

Answer 17

anxiolytic effects takes 1-2 weeks

lacks anticonvulsant and muscle relaxant properties

Question 18

what are barbiturates

Answer 18

potentiate GABA mediated Cl- currents but at a site distinct from benzos
used as a sedative-hypnotic

Question 19

disadvantage of barbiturates

Answer 19

severe withdrawal symptoms

flumazenil not effective to treat OD

Question 20

Usage of long acting barbiturates

Answer 20

anticonvulsant (phenobarbital)

Question 21

usage of short acting barbiturates

Answer 21

sedative and hypnotic (pentobarbital and amobarbital)

Question 22

usage of ultrashort acting barbiturates

Answer 22

IV induction of anaesthesia (thiopental)

Question 23

what is pregabalin

Answer 23

GABA analogue, increases synaptic GABA –> GABA receptor mediated Cl- currents resulting in hyper polarisation
acts on voltage-gated Ca2+ channels

Question 24

does pregabalin have anticonvulsant effects

Answer 24

yes

Question 25

SE of pregabalin

Answer 25

may be associated with emergence or worsening of suicidal thoughts

Question 26

what is hydroxyzine

Answer 26

1st gen antihistamine with activities on serotonergic and alpha-adrenergic receptors
anxiolytic effects attributed to antagonism of serotonin 5-HT2 receptors

Question 27

advantages of hydroxyzine

Answer 27

low addictive potential

helps with itching (during anxiety)

Question 28

what is propranolol

Answer 28

beta adrenergic receptor antagonist
treat performance anxiety and social phobias
reduce physical symptoms associated with adrenergic activation

Question 29

when is propranolol contraindicated

Answer 29

asthma and heart conditions