Anxiolytics and Hyponotics Flashcards
Outline the types of anxiolytics
Buspirone
Pregabalin
Benzodiazepines
Beta-blockers
What is the indication for anxiolytics?
Second line treatment for anxiety disorders
Describe the mechanism of action of Benzodiazepines
Enhances action of GABA at GABA-A receptors
What are the indications for Benzodiazepines? Name the specific drug used for each indication
Rapid relief of anxiety - Lorazepam
Short term treatment of insomnia - Temazepam
Alcohol detoxification - Diazepam
Describe the pharmacokinetics of Lorazepam
Fast onset
Short acting
Describe the pharmacokinetics of Diazepam
Slower onset
Longer action
State a precaution of starting benzodiazepines
Dependence
Withdrawal
What happens if benzodiazepines are stopped abruptly?
Acute withdrawal:
- Anxiety
- Insomnia
- Seizures
- Death
Name 3 side affects of benzodiazepines
Drowsiness Light headiness Ataxia Confusion Amnesia Paradoxical agitation Disinhibition
List 3 signs and symptoms of benzodiazepine overdose
Drowsiness Ataxia Dysarthria Nystagmus Coma Respiratory depression
What is the mechanism of action of Buspirone?
Partial serotonin agonist
Name the indication for Buspirone
Short term relief of GAD
Name 2 side effects of Buspirone
Light headedness
Nausea
Dizziness
What is the mechanism of action of Pregabalin?
Inhibits glutamate, noradrenaline, and substance-P
Name 2 indications for Pregabalin
GAD
Neuropathic pain
List 3 side effects of Pregabalin
Dizziness Drowsiness Blurred vision Diplopia Confusion Vivid dreams
What information should be given when stopping Pregabalin?
Avoid abrupt withdrawal. Taper over 1 week.
What is the indication for use of Beta-blockers in anxiety?
Patients with predominantly somatic symptoms of anxiety
What are the somatic signs and symptoms of anxiety?
Headaches Chest tightness Tachycardia and palpitations Perspiration Dizziness Shortness of breath Insomnia and restlessness Loss of appetite/stomach discomfort Muscle ache
Name 3 hypnotic medications
‘Z drugs’
- Zopiclone
- Zolpidem
- Zalepon
Describe the mechanism of action of hypnotics
Acts on benzodiazepine GABA-A complex
What is the indication for hypnotics?
Second line treatment of insomnia (short term)
*Sleep hygiene is first line treatment
How do Z drugs differ from Benzodiazepams?
Short half-life
Less dependence potential
