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D&T2 Exam 1 > Anxiolytics Drugs - Egleton > Flashcards

Anxiolytics Drugs - Egleton Flashcards

1
Q

what part of the brain is involved with fear

A

amygdala

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2
Q

what part of the brain is involved with worry

A

cortico-striato-thalamo-cortico loop circuit

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3
Q

what are the first line of drugs to treat anxiety

A

SSRI

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4
Q

what are the 2nd line of drugs to treat anxiety

A

TCA

Benzodiazepines

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5
Q

SSRI is commonly used in what medical condition

A

depression

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6
Q

What is SSRI used for

A
  • treatment of anxiety disorders

- PTSD: reduces flashbacks, arousal, and avoidance

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7
Q

what is the onset of action for SSRI

A

2-4 weeks

slow

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8
Q

what are sides effects of SSRI

A

Jitters potentially some increased anxiety initially

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9
Q

name a SNRI drug

A

Venflaxine

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10
Q

what are SNRI commonly used to treat

A

depression

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11
Q

what is a difference between SNRI and SSRI

A

SSRI: serotonin
SNRI: serotonin and NE

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12
Q

what is SNRI used for

A

treatment of most anxiety disorders
PTSD: reduce flashbacks, arousal, and avoidance
Co-morbid pain disorders

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13
Q

what is the onset for SNRI to start working

A

very slow

2-4 weeks

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14
Q

what is a side effect of SNRI

A

jitters, potentially some increased anxiety initially

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15
Q

what are jitters

A

paradoxical increase in anxiety, restlessness, insomnia in first weeks of drugs

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16
Q

how can jitter problem be fixed with SSRI and SNRi

A

take with Benzodiazepine for short term

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17
Q

Name two SSRI drugs

A

Fluoxetine

Sertraline

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18
Q

Imipramine is used when and what type of drug

A

second line

TCA ( tricyclic antidepressant)

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19
Q

What is Imipramine used for

A

GAD

panic disorders if SNRI and SSRI are ineffective

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20
Q

Benzodiazepines MOA

A

enhance GABA binding to GABA receptor

  • increase frequency of opening channel
  • increases Cl- flux into cell
  • hyper polarizes
  • inhibition of cell acitivity
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21
Q

GABA initiates signaling from where

A

amygdala

cortico-striato-thalamo-cortico-loop

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22
Q

Benzodiazepines have different levels of CNS effects. what are they

A
  1. relief of anxiety
  2. sleep induction
  3. anesthetic effects
  4. coma and death
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23
Q

when is coma and death seen with Benzodiazepines

A

in conjunction with other depressants like Alcohol

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24
Q

At what dose does Benzodiazepines have respiratory effects

A

Anesthetic dose

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25
what does Benzodiazepines have cardiovascular effects
none, except at high doses
26
Benzodiazepines are very soluble in what
lipids
27
how does Benzodiazepines work in the GI
completely absorbed | - antacids prevent absorption
28
how does Benzodiazepines effect pregnant women
crosses placenta | secreted into breast milk
29
how does the hepatic metabolism impact Benzodiazepines
- active metabolites generated | - 1/2 life of active metabolites is higher then parent compound
30
explain phase I , II, III of active metabolism of Benzodiazepones
I:  initial oxidation step, quickest reaction.  Inhibited by cimetidine. II:  Hydroxylation at R3 to yield another active metabolite, slowest reaction III:   Glucuronidation followed by urinary excretion
31
Which Benzodiazepones are useful for patients with liver disease
Oxazepam | Lorazepam
32
what are the most common side effects of Benzodiazepones
Drowsiness and confusion
33
what is a anesthesia side of effect of Benzodiazepones
anterograde amnesia | forget experience 1-3 hours after dose
34
what is a side effect of Benzodiazepone
rebound... dose tapering required for short half-life drugs
35
Benzodiazepone have what drug interaction and can this lead to
alcohol and other depressants | - respiratory depression and death
36
what Benzodiazepone drugs should be given to elderly and why
Lorazepam and Oxazepam | 1/3 or 1/2 dose should be given
37
What Benzodiazepone drugs should not be given to COPD patients
Midazolam
38
how does Benzodiazepone drug impact obstructive sleep apnea
muscle relaxant of Benzodiazepone
39
what happens in alcohol and Sedative-hypnotic mixed withBenzodiazepone
respiratory depression
40
what Benzodiazepone drugs should not be given to pregnant women
Chlordiazepoxide | diazepam
41
what kind of dependence can occur with Benzodiazepone
physcial
42
what are frequent withdrawal symptoms of benzodizepone
anxiety | insomnia
43
what are rare withdrawal symptoms for Benzodiazepone
siezures
44
benzodizepone: Diazepam
direct muscle relaxant
45
benzodizepone: alprazolam
panic disorder
46
benzodizepone: triazolam
rebound anxiety and insomnia
47
benzodizepone: antiemetic
antimemetic -- prevent vomiting
48
what is Flumazenil
BDZ antagonist
49
what is Flumazenil used for
BDZ overdose
50
what is the disadvantage for using Flumazenil
 may precipitate withdrawal; may cause seizures if BDZ is used to control seizure activity
51
mechanism of action for Buspirone
agonist for 5-HT (post and presynaptic)
52
what is Buspirone used for
treatment of GAD
53
what are 3 characteristics of Buspirone
- lacks sedative, anticonsuvlsants and muscle relaxant effects - no interaction with alcohol or other CNS depressans - good for substance abuse patients
54
what is the mechanism of action for Pregabalin
blocks voltage sensitive calcium channels - binds to presynaptic N and P/Q channel alpha2gamma - prevents release of excitatory neurotransmitters in amygdala and CTSC
55
what is Pregabalin used for
GAD | social generalized
56
compare the effectivness of Meprobamate and BDZ
Not as effective as BDZ’s  
57
what caution needs to be taken for Meprobamate
contraindicated in prophyrias
58
how does Propanolol work
nonselective beta-adrenergic blocker
59
what is Propanolol used for
short term anxiety
60
what is Hydroxyzine
antihistamine | H1 receptor antagonist
61
what is Mirtazapine
5HT2 receptor antagonist
62
side effects of Mirtazapine
weight gain and sedation

D&T2 Exam 1 (22 decks)

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