Anxiolytics And Hyponotics Flashcards
What are anxiolytic drugs
Benzodiazepines
Benzodiazepines mechanism of action
Benzodiazepines act on the site between alpha and gamma that facilitate GABA-A binding and increase in frequency of Cl- channels opening
What is GABA
main inhibitor transmitter in the brain
Whats the difference between GABA A and B
A - occurs post synapticalky coupled to cl ions
B - G protein coupled receptor
only drug that acts on GABA B
Baclofen
List benzodiazepines
End with lam and Pam, have diaze in them Alprozalam Chlordiazepoxide Diazepam Lorazepam Midozolam Cholnazepam
What are the subtypes of GABA A
Alpha1 GABA A - hypnotic
Alpha2 GABA A - anxiolytics (muscle relaxant
All benzodiazepines act on a1 what can that cause
Sedation
Duration of action of benzodiazepines
3-8hrs short acting
8-24hr medium acting
>24hrs long acting
Long acting benzodiazepines
Diazepam, chlordiazepoxide
Medium acting benzodiazepines
Lorazepam
Short acting benzodiazepines
Midozalam and Alprazolam
Which benzodiazepines are used for skeletal muscle spasm
Diazepam
Which benzodiazepines are used for alcohol withdrawal
Diazepam
Which benzodiazepines are used for anaesthesia
Midozalam
Which benzodiazepines are used for sleep disorders
Midozalam
Which benzodiazepines are used for anxiety
Diazepam, chlordiazepoxide, lorazepam and alprazolam
Which benzodiazepines are used for seizures
Diazepam, lorazepam and clonazepam
What is status epilepticus
Life threatening condition where the brain is in a state of presistant seizures
Benzodiazepines toxicity from overdosage
CNS and RESPIRATORY depression
Benzodiazepines side effects
Amnesia, anterograde amnesia, Slurred speech, interferes with driving and psychomotor skills
Can benzodiazepines be given to pregnant women
No it’s Teratogenic
What can you develop with benzodiazepines
Tolerance and dependence
Benzodiazepines antidote
Flumazenil - reverses CNS depression
Which benzodiazepine is used for insomnia
Flunitrazepam
Which diazepams are advised for the elderly
Short acting
Contraindications to take with benzodiazepines
Alcohol
How to stop giving benzodiazepines
Dose reduction should be gradual when taking off medication
What is used for chronic anxiety
Buspiron
What is buspiron
Partial agonist of 5-HTa receptor
How long does buspiron take to start working
It takes days to weeks to produce effect in men
Which antihistamines are used as anxyolytics
Hydroxyzine and promethazine
Beta blockers used for anxiety- specially stage fright
Propanolol and atenolol
When shouldn’t hypnotics be used
Shouldn’t be used before driving machinary or activity
Insomnia definition
Difficulty initiating sleep, maintaining sleep and sleep disturbances at least 3 times a week
Which benzodiazepine is used for insomnia
Midozalam
Which antidepressants have hypnotic effects could be used for insomnia
Doxepin - most sedative antidepressant
Trazadon
Mirtazapine - blocks H1
What herb is used as a hypnotic
Valerian herb
List non benzodiazepines hypnotic drugs
Z agents Zopiclone Zolpidem Eszopiclone Zaleplon
Which from the Z agents have short half life
Z agents
Zopiclone
Zolpidem
Eszopiclone
Which from the Z agents have ultra short half life
Zaleplon
What do the Z agents act on and what can they cause
They act on a1 GABA A receptor and can cause tolerance and dependence
What is used to regulate jet lag and artificial jet lag syndrome
Melatonin hormones
Agonists of MT1 and MT2 of melatonin receptors
List the melatonin hormones
Ramelteon- increases prolactin level
Tasimelton- abnormal dreams
Agomelatine
What is suvorexant
Antagonist at orexin receptors
What is orexin
Neuropeptide promoting wakefulness
Suvorexant side effects
Signs of narcolepsy and cataplexy and increase suicidal ideation
What are z agents metabolised by
P450
What can Z agents cause
Anterograde amnesia
What happens when we mix
Phenobarbital/benzodiazepines with alcohol
Induces respiratory depression
