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Psychiatric Pharmacology > Anxiolytics > Flashcards

Anxiolytics Flashcards

1
Q

Fight or Flight response has a peripheral noradrenergic response mediated via ____ and a central adrenergic reaction mediated via ______.

A
  1. NA/NE

2. adrenaline/epinephrine

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2
Q

The stress response involves the ____ axis and secretion of ______

A
  1. Hypothalamus-pituitary-adrenal(HPA)axis

2. cortisol (stress hormone)

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3
Q

Therapeutic rationale of sedatives is to cause _____ and ______. (Patient is still conscious)

A

sedation

relaxation

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4
Q

Therapeutic rationale of _____ is to induce drowsiness, sleep and may have amnestic effects.

A

Hypnotics

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5
Q

Anxiolytics reduce _____.

A

anxiety

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6
Q

The same anxiolytic can have more than one action depending on dose.

  • Low dose = _______
  • Higher doses = _______
  • Even higher doses = ________
A
  1. anxiolytic and sedative effects
  2. hypnotic
  3. can cause anesthesia, used for surgery
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7
Q

Benzodiazepines can be used as anxiolytics/sedatives (i.e. ________).

A

diazepam, lorazepam

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8
Q

Benzodiazepines that can be used as hypnotics (i.e. _________, _________, _________).

A
  1. diazepam
  2. triazolam
  3. temazepam
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9
Q

Benzodiazepines can be used as _______ (i.e. diazepam, midazolam).

A

pre-anaesthetics

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10
Q

Benzodiazepines can have anti-convulsant effects (i.e. ______).

A

diazepam

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11
Q

Benzodiazepines can have anti-convulsant effects (i.e. ______).

A

diazepam

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12
Q

Non-BZDs include Barbiturates (eg _________), _______, ________ and Propranolol etc.

A
  1. phenobarbital
  2. Buspirone
  3. Zolpidem
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13
Q

BZD binding potentiates the binding of ______ receptor binding site, making GABA-A open more easily, Potentiates __________ leading to _______= neurons not firing

A
  1. GABA to GABA-A
  2. influx of Cl-ions
  3. Hyperpolarization
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14
Q

GABA binding, enhanced by BZDs leads to ______ (limbic system), ______ (reticular activating system) and ________ (motor cortex).

A
  1. altered mood
  2. drowsiness
  3. relaxed muscles
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15
Q

The longer acting BZDs are more appropriate for ______ to reduce dose frequency and have a duration of ______.

A
  1. chronic conditions

2. 1-3 days

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16
Q

The Short acting BZDs are more appropriate for ______ and can last ______.

A
  1. General anesthesia induction

2. 3-8hrs

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17
Q

The intermediate acting BZDs can last ______.

A

10-20hrs

18
Q

BZDs can cause _________, especially used concurrently with alcohol.

A

severe respiratory depression

19
Q

Treatment of BZD overdose is using ______, a benzodiazepine antagonist

A

flumazenil

20
Q

Side effects of BZDs are related to CNS depression and include: ______, _______, _______. and impaired muscle co-ordination (which is why we must counsel pts _______).

A
  1. Drowsiness
  2. confusion
  3. amnesia
  4. Not to operate heavy machinery
21
Q

BZD tolerance depends on ______ of use. Therefore, tolerance develops ______for epilepsy than use to induce sleep.

A
  1. frequency

2. faster

22
Q

Dependence for BZDs can develop and BZDs have abuse potential. Withdrawal effects include: _____, rebound _____, tremor and ______.

A
  1. disturbed sleep
  2. anxiety
  3. convulsions
23
Q

A key strategy to avoid BZD dependence is to ______.

A

Withdraw gradually

24
Q

Zolpidem has the ______ but different _____ compared to BZDs. It is ____effective than anxiolytics.

A
  1. same MOA
  2. structure
  3. less
25
Q

Zolpidem has a good _____ effect and is primarily used to treat ________.

A
  1. hypnotic

2. insomnia

26
Q

Buspirone is a _____ receptor partial agonist that also binds _____ receptors.

A
  1. 5-HT1A

2. dopamine

27
Q

Buspirone is indicated for GAD but anxiolytic effects require ______. It also lacks anti-convulsant and _______ properties.

A
  1. take 1-2 wks

2. muscle relaxant

28
Q

Barbiturates have the same ______ but different _______ compared to BZDs. At anesthetic doses, barbiturates (i.e. phenobarbital) can _____________ as well as block Na+ channels.

A
  1. MOA
  2. binding site
  3. directly open CL- channels (no longer potentiates)
29
Q

Barbiturate use as a sedative-hypnotic has largely been replaced by BZDs due to barbiturate’s increased tendency to ________. Flumazenil is _____ in treating Barbiturate overdose.

A
  1. develop tolerance and dependence

2. not effective

30
Q

Barbiturates have _____ withdrawal symptoms.

A

severe

31
Q

Long acting barbiturates meant for anti-convulsant use have a duration of action of 1-2 _____. (i.e. _____)

A
  1. days

2. phenobarbital

32
Q

Short acting barbiturates meant for sedative and hypnotic use have a duration of action of 3-8 _____. (i.e. _____ and ______)

A
  1. hrs
  2. pentobarbital
  3. amobarbital
33
Q

Ultra-short acting barbiturates meant for induction of anesthesia have a duration of action of 20 _____. (i.e. _____ )

A
  1. mins

2. thiopental

34
Q

BZDs are ____ likely to cause respiratory depression compared to barbiturates.

A

less

35
Q

At higher doses, barbiturates cause _____ depression and can even result in _____.

A
  1. medullary

2. coma

36
Q

Pregabalin acts by _______, resulting in hyperpolarization. It also acts on _____channels.

A
  1. increasing synaptic GABA

2. voltage gated Ca2+

37
Q

Pregabalin has ______effects and is used in treatment of _____ but may be associated with emergence or worsening of ______.

A
  1. anticonvulsant
  2. GAD
  3. suicidal thoughts
38
Q

Hydroxyzine is a 1st gen anti-histamine with effects on _____ and ______ receptors. Its anxiolytic effects are due to antagonism of ______ receptors. It can also help with _____ due to its anti-histamine activity.

A
  1. serotonergic
  2. α-adrenergic
  3. serotonergic
  4. itching/nausea related anxiety
39
Q

Hydroxyzine has ____ addictive potential compared to BZDs and barbiturates.

A

lower

40
Q

Propranolol can be used for treating _________ and _____ phobias. It reduces the physical symptoms associated with adrenergic activation i.e. tachycardia and _______.

A
  1. performance anxiety
  2. social
  3. muscle tremors
41
Q

Propranolol is Contraindicated in patients with _____ and ______ conditions. (including predisposition)

A
  1. asthma

2. heart

42
Q

Many other depressants also serve as anxiolytics as the 2 conditions may share the same chemical basis. They include _______ (NaSSA), _______ (TCA), Fluoxetine, citalopram, sertraline, paroxetine (____) and Venlafaxine, duloxetine (_____).

A
  1. Mirtazapine
  2. Clomipiramine
  3. SSRI
  4. SNRIs

Psychiatric Pharmacology (8 decks)

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