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z) Pharmacology > Anxiolytics and Hypnotics > Flashcards

Anxiolytics and Hypnotics Flashcards

1
Q

Anxiety disorders types

A

Panic disorders
Phobias
Social anxiety disorder
Generalised anxiety disorder

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2
Q

Stress disorder

A

PTSD

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3
Q

OCD symptoms

A

Thoughts a terrible event will occur, need for perfection with repetitive ritualistic behaviour

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4
Q

Sleep disorder types

A

Insomnia:
transient - noise/shift work/jet lag
Intermediate - illness/emotional episode
Chronic - psychiatric disorder

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5
Q

Anxiety and stress disorder treatments aim to

A

increase inhibition in limbic system as these are associated with increased glutamatergic activity

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6
Q

BDZ MOA

A

Binds to BDZ receptor on GABA-A receptors, potentiates GABA action and more chloride passing through

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7
Q

BDZ SE

A 
Drowsiness
Agitation
Ataxia
Addiction
Interact with depressants
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8
Q

BDZ uses

A

Short term anxiety e.g. bereavement

Sedation/amnesia so traumatic awake surgical procedures

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9
Q

BDZ antagonist

A

Flumazenil short duration of action, used to reverse benzo activity

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10
Q

Midazolam duration and uses

A

4 hr

Amnesic, pre-med surgery e.g. endoscopy

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11
Q

Lorazepam, oxazepam, temazepam duration and uses

A

15 hr

Anxiolytic, hypnotic

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12
Q

Alprazolam, nitrazepam duration and uses

A

24 hr

Anxiolytic, panic attacks

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13
Q

Chlordiazepoxide, diazepam duration and uses

A

48 hr
Anxiolytic, muscle relaxant
Diazepam is anticonvulsant

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14
Q

Clonazepam, Flurazepam duration and uses

A

60 hr

Anticonvulsant, anxiolytic

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15
Q

flunitrazepam use

A

Roofies, rohypnol

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16
Q

Z drugs use

A

Zolpidem, zopiclone, zaleplon and eszopiclone preferred as hypnotics
Pagoclone, suproclone used as anxiolytic

17
Q

Z drugs MOA

A

Zolpidem, zopiclone, zaleplon act at BDZ binding site but not BDZ

18
Q

Natural anxiolytics

A

Neurosteroids derived from progesterone/corticosterone such as allopregnanolone made in neurones and GABA cells
Diazepam binding inhibitor protein, binds at BDZ site in thalamic reticular nucleus

19
Q

Serotonergic system and anxiety

A

5HT1A receptors are inhibitory auto receptors, when activated reduces 5HT and increases anxiety

20
Q

Buspirone treatment MOA

A

Partial 5HT1A agonist, acutely causes less 5HT release but eventually desensitises receptors and lots of 5HT released after a few weeks

21
Q

Beta blockers MOA

A

Propranolol reduces physical manifestations of anxiety e.g. sweating, tremor, tachycardia by blocking beta-2

22
Q

Anti-depressants used in anxiety

A

SSRIs (fluoxetine, paroxetine) and SNRIs (venlafaxine, duloxetine) used in GAD, SAD, PTSD, phobias

23
Q

Anti-convulsants used in anxiety

A

Ca channel blockers (gabapentin, pregabalin), GABA uptake blocker (tiagabine) and GABA metaboliser (valproate) used for GAD

24
Q

Anti-psychotics used in anxiety

A

D2 antagonist (olazapine, linked to Gi so inhibits adenylate cyclase) and risperidone used for GAD, PTSD

25
Q

Chlormethiazole use

A

Hypnotic which potentiates GABA receptors, used for elderly as no hangover effect which could cause confusion/falls
Is a barbiturate

26
Q

Advice for hypnotic use

A

short term treatment preferred
tolerance develops over 2 weeks
withdrawal over a few weeks, rebound insomnia, vivid dreams

27
Q

Barbiturates MOA

A

Thiopental, amylobarbitone, secobarbital, butobarbital, phenobarbitone, clomethiazole acts via GABA-A receptor even in absence of GABA

28
Q

Barbiturates use

A

no longer used, except sometimes as anticonvulsants (phenobarbital) and even more rarely as anaesthetic (thiopental)

29
Q

Barbiturates SE

A

Resp depression
Easy to OD so natural antagonists
Dependence

30
Q

Meprobamate use

A

No longer used as less potent than BDZ but more toxic

31
Q

Non-prescription anxiolytics/sedatives

A

Antihistamines (diphenhydramine, promethazine)

Valarian extract potentiates GABA receptor function

z) Pharmacology (24 decks)

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