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Psychopharm > Anxiolytics/hypnotics > Flashcards

Anxiolytics/hypnotics Flashcards

1
Q

Choice of benzodiazepine based on —? (3)

A
  1. Time to onset of action
  2. Duration of action
  3. Method of metabolism
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2
Q

What are the 4 short half-life benzos?

A
  1. Alprazolam (Xanax)
  2. Lorazepam (Ativan)
  3. Oxazepam (Serax)
  4. Temazepam (Restoril)
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3
Q

What are the 3 long half-life benzos?

A
  1. Clonazepam
  2. Diazepam
  3. Chlordiazepoxide
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4
Q

Which benzo is used for alcohol detoxification?

A

Chlordiazepoxide

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5
Q

Which benzos are not metabolized by the liver? (thus safe to use in chronic alcoholics or liver disease) (3)

A

LOT

  1. Lorazepam
  2. Oxazepam
  3. Temazepam
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6
Q

Which long half-life benzo has the fastest onset?

A

Diazepam

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7
Q

What can be used to treat benzo overdose?

A

Flumazenil (benzo antagonist)

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8
Q

Side effects of benzos (5)

A
  1. Drowsiness
  2. Dizziness
  3. Reduced motor coordination (ataxia) careful in elderly
  4. Cognitive impairments
  5. Amnesia
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9
Q

What are the withdrawal symptoms of benzos? (6)

A

anxiety, insomnia, restlessness, agitation, irritability, muscle tension

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10
Q

What are the 5 nonbenzo hypnotics?

A
  1. Zolpidem
  2. Zaleplon
  3. Eszopiclone
  4. Diphenhydramine (Benadryl)
  5. Ramelteon
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11
Q

Which nonbenzo hypnotics are GABAergic?

A

Zolpidem, zaleplon, eszopiclone (3 Zs)

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12
Q

Rank the half-lives of zolpidem, zaleplon, eszopiclone in order of increasing half lives

A

Zaleplon > Zolpidem > Eszopiclone

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13
Q

What are the side effects of the 3 Zs?

A
  1. Dizziness

2. GI side effects (nausea, vomiting, dyspepsia)

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14
Q

What is diphenhydramine?

A

antihistamine

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15
Q

What is the mechanism of action of Ramelteon?

A

Selective melatonin MT1 and MT2 agonists

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16
Q

What are the non-benzo anxiolytics? (3)

A
  1. Buspirone (BuSpar)
  2. Hydroxyzine (Atarax)
  3. Propranolol
17
Q

Mechanism of action of Buspirone?

A

partial agonist of 5HT1A

18
Q

What is the onset of action of buspirone?

A

1-2 wks for effect (slower onset of action than BDZ)

19
Q

What is the indication of buspirone?

A

often used as an ADJUNCT for treatment of GAD or MDD

20
Q

Mechanism of action of hydroxyzine?

A

antihistamine

21
Q

Indications for hydroxyzine?

A

Pts who want quick-acting, short-term medication, but who cannot take benzos for various reasons
- situational anxiety

22
Q

Propranolol is useful in treating –? (2)

A
  1. Autonomic effects of panic attacks or performance anxiety (ex. palpitations, sweating, tachycardia)
  2. Akathisia (s/e of typical antipsychotics)

Psychopharm (5 decks)

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