Anxiolytics and Sedatives

Question 1

what do we mean by a drug labeled as a hypnotic?

Answer 1

induces drowsiness, decreases cognitive performance, allows onset and maintenance of sleep

Question 2

what specific portion of the brain induces the “fight or flight” motor response?

Answer 2

striatum

Question 3

what part of the brain induces the hormonal stress response?

Answer 3

hypothalamus

Question 4

what portion of the brain is the center of emotion and memory of it?

Answer 4

amygdala

Question 5

where is melatonin released from?

Answer 5

the pineal gland

Question 6

what is the suprachiasmatic nucleus (SCN)?
what does it regulate?
what activates the SCN?

Answer 6

the master clock in the hypothalamus
the pineal gland
light, so it stimulates the pineal gland to produce melatonin at night

Question 7

what is GAD?

Answer 7

generalized anxiety disorder: excessive anxiety and worry most of the time

Question 8

what is panic disorder?

Answer 8

discrete periods of intense fear

Question 9

how do benzodiazepines potentiate GABA?

Answer 9

they increase GABAs ability to bind more tightly to their receptors. They do not increase efficacy

Question 10

what is the main disadvantage of using SSRIs, SNRIs, and TCAs for anxiety?

Answer 10

slow onset of action

Question 11

what is tyramine metabolized by?

Answer 11

MAO-A

Question 12

why is excessive tyramine bad when using MAOIs?

Answer 12

you’re blocking the metabolism of tyramine. when it is elevated it can increase BP and cause a fatal hypertensive crisis

Question 13

what NT does tyramine increase the release of?

Answer 13

NE

Question 14

beta blockers can be used for which forms of anxiety disorders?
which two beta blockers are used?

Answer 14

performance or social anxiety
propranolol and atenolol

Question 15

what symptoms in specific can beta blockers help with for anxiety?

Answer 15

physiological symptoms: palpitations, tremor, GI upset

Question 16

what drug class is busprione?

Answer 16

5-HT1A agonist

Question 17

buspirone is an effective treatment for anxiety without what other side effects?

Answer 17

no sedative, hypnotic, anticonvulsant, muscle relaxant properties

Question 18

what does buspirones activity as a partial agonist at 5-HT1A receptors do in regards to sertraline?

Answer 18

it dampens sertraline release and decreases its firing rate

Question 19

why is buspirone not a good treatment for acute anxiety?

Answer 19

it takes 2-4 weeks for its effects

Question 20

what is the most common side effect of buspirone?

Answer 20

dizziness

Question 21

what is buspirone’s active metabolite? what drug class is it? what is a major concern about its metabolite?

Answer 21

1-PP
alpha2 antagonist
can exacerbate panic attacks

Question 22

why can antidepressants make people feel more anxious?

Answer 22

increasing serotonin can boost emotional activity

Question 23

why do benzos lose efficacy overtime?

Answer 23

development of tolerance

Question 24

how do sedative-hypnotic drugs treat alcohol withdrawal?

Answer 24

we can wean patients off alcohol dependence using these drugs to reduce withdrawal symptoms

Question 25

which of the benzos are commonly used for insomnia?

Answer 25

triazolam
estazolam
temazepam
flurazepam
quezapam

Question 26

what are the three “z”drugs?

Answer 26

zaleplon
zolpidem
eszopiclone

Question 27

how do barbiturates help with anxiety?

Answer 27

they increase the efficacy of GABA by binding to an ALTERNATIVE binding site on GABA receptors and increase their duration of opening

Question 28

what happens if the picrotoxin site of a GABA receptor is blocked?

Answer 28

convulsions occur due to blocking hyperpolarization