Anxiolytics and Sedatives Flashcards
What drugs reduce anxiety?
Anxiolytics
What drugs induce sedation and reduce anxiety?
Sedatives
What drugs induce drowsiness and sleep from which one can be aroused?
Hypnotics
When does anxiety become a disorder?
When it begins to interfere with normal life. When it is no longer useful as a warning system.
What part of the brain is used in the limbic system when anxiety and fear is involved?
The amygdala
What is the ascending arousal system?
It is the state of CNS activity and reactivity leading from sleep to wakefulness to excitement to panic . This is opposed to to the GABA system which promotes sleep.
What pathway needs to be shut off in order to sleep?
The ascending arousal pathway
What small molecules are used in the regulation of sleep?
Glutamate NE ACh 5-HT DA
What aa is used in the regulation of sleep?
GABA
What neuropeptide is used in the regulation of sleep?
Orexin/hypocretin
What else is present in the ascending arousal pathway?
Histamine. Specifically H1 (H1 antagonist has strong sedating and anti-emetic effects. H2 doesn’t cross BBB and has low CNS effects)
What biological components are important in the arousal system?
Biological clocks
Pineal gland (releases melatonin)
Suprachiasmic Nucleus - master clock in hypothalamus
Retina - light (synchronizes the endogenous clock)
What are some subjective features that are linked with anxiety?
Apprehension Worry Anticipation Fear Jumpiness Restlessness Impaired concentration Comorbid depression
What are some physiological features that are linked with anxiety?
tension, fatigue, tremor
dry mouth, difficulty swallowing
hyperventilation
palpitations
GAD
generalized anxiety disorder - excessive anxiety and worry most of the time about life
Panic disorder
discrete periods of intense fear
phobic anxiety disorder
irrational fear that interferes with normal behavior
SAD
social anxiety disorder
OCD
obsessive compulsive disorder (persistent thoughts/ideas and impulses for intentional behaviors)
PTSD
normal reaction to abnormal event
acute stress disorder
reaction to recent stress, lasts less than 6 months
What is the goal for a good anxiolytic?
A non-sedating drug that works against anxiety
Benzodiazepines
- mechanism
- advantages
- disadvantages
- GABAa receptors in the limbic system that control emotional behavior
- rapid onset, high therapeutic index, effectiveness for acute and other form of anxiety (not GAD)
- tolerance, CNS depressant/sedative, impaired cognition, additive alcohol danger, dependency
What do BZD’s do to the GABA receptor?
They increase the frequency of channel opening = enhanced inhibition.