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Pharm > Benzo's > Flashcards

Benzo's Flashcards

1
Q

When does anxiety occur?

A

reaction when people are facing tough situations

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2
Q

If anxiety occurs frequently it can

A

decrease the quality of life

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3
Q

Non pharmacological treatments for anxiety (3)

A
  • psychotherapy
  • cognitive therapy
  • supportive thereapies
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4
Q

what can we use for anxiety? drugs (6)

A

-Benzodiazepines
-antidepressants
other:
- antihistamine (sedative effect)
-neuroleptics
-B-blockers
-anticonvulsants

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5
Q

What is the mechanism of action for benzo’s?

A

-increase sensitivity of the GABA receptors in SNC

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6
Q

Benzodiazepines are the drug of choice for: (2)

A

insomnia and anxiety

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7
Q

Side effects of benzo’s (5)

A
  1. Sleepiness, stupor, coma.
  2. Decrease in alertness and attention.
  3. Disorientation, ataxia and agitation. (careful in elderly >60)
  4. Dependence(>6months) and withdrawal syndrome
  5. Respiratory center depression.
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8
Q

What is flumazenil? what route of administration do we use?

A

benzo’s antidote

IV

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9
Q

What is the antidote for benzos and how do they work? what route of administration do we use?

A
  • block gaba receptors
  • flumazenil
  • IV
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10
Q

When does disorientation, ataxia and agitation with benzo’s occur? (4)

A
  • Uncommon.
  • In elderly.
  • People> 60 year old are advised to start with half of the adult dose.
  • Manifestations of the CNS depressant effect.
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11
Q

When does anterograde amnesia occur with benzos? (2)

A
  • Medium to high doses.

- The memory process is altered.

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12
Q

Define hypnosis

A

induction of a state of sleep artificially by the action of various drugs

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13
Q

Define hypnotics

A

drugs used in the treatment of insomnia and produce a “similar” pattern of sleep.

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14
Q

Define normal sleep

A

a succession of phases of slow sleep or non- REM and REM sleep or rapid sleep of about 100 minutes

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15
Q

What drugs treat insomnia (2)

A
  • drugs used as hypnotics

- the benzodiazepines (BZD) (-zepam or -zolam)

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16
Q

Subjective feelings of restlessness, uncertainty, and fear without apparent cause is called….

A

anxiety

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17
Q

Physical symptoms that accompany anxiety are… (5)

A
  • sweating
  • tremor
  • tachycardia
  • chest pain
  • shortness of breath
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18
Q

What is the mechanism behind anxiety

A

hyperactivity of sympathetic nervous system w/ circulating catecholamines

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19
Q

THE ONLY ANXIOLYTICS (SPECIFICALLY FOR ANXIETY DISORDERS) USED NOWADAYS ARE

A

benzodiazepines

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20
Q

Benzodiazepines are what drug class?

A

anxiolytics

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21
Q

What does GABA stand for?

A

γ-aminobutyric acid (gamma)

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22
Q

GABA produces…

A

central inhibition

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23
Q

Benxiodiazapines have the effects of these drugs…(4)

A
  • anxiolytics
  • anticonvulsivants
  • hypnotics
  • muscle relaxants

*the predominance of these effects depends on the drug type

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24
Q

Benzo’s are classified according to… (5) What are the 4 types?

A

duration of action:

  • ultra short action (half-life <5hrs)
  • short action (half-life ~12hrs)
  • intermediate (half-life ~24hrs)
  • long action (half-life >24hrs)
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25
Q

What is the ultrashort action benzo?

A

midazolam

26
Q

What are the short action benzos? (2)

A
  • lorazepam

- alprazolam

27
Q

What are the intermediate action benzos? (2)

A

flurazepam

bromazepam

28
Q

What is the long short action benzo?

A

diazepam

29
Q

benzo’s have excellent ____ absorption

A

oral

30
Q

benzo’s have ____ bioavailability

A

high

31
Q

how do benzo’s behave intramuscularly

A

erractic and slow absorption

32
Q

How do benzo’s behave intravenously?

A

better than IM

33
Q

can benzo’s be given rectally?

A

yes

34
Q

benzos have ____ protein binding

A

high

35
Q

How are benzo’s metabolized?

A
  • hepatic

- active metabolites

36
Q

Are benzo’s excreted easily?

A

yes

37
Q

Benzo indications? (6)

A
  • anesthesia
  • insomnia
  • anxiety
  • epilepsy
  • alcohol withdrawal
  • muscular relaxation
38
Q

What bezno is used for anesthesia and why? (4)

A

Midazolam (IV)

  • ultrashort action
  • induction and maintenance of anesthesia
39
Q

What bezno is used for insomnia and why? (9)

A
  • short action or intermediate action (P.O.)
  • induce sleep + calming effect
  • lorazepam
  • lormetazepam
  • hypnotic and sedative
40
Q

What bezno is used for anxiety and why? (2)

A
  • long action (P.O)

- reduce / eliminate anxiety

41
Q

What bezno is used for alcohol withdrawl and why? (2)

A
  • long action (P.o)

- diazepam (in delitium tremens)

42
Q

What bezno is used for muscular relaxation and why? (5)

A
  • useful for spasms (contractions) and torticollis (stiff neck)
  • tetrazepam (now discontinued)
  • low doses of diazepam
  • makes the pateint drowsy
43
Q

whats toticollis?

A

stiff neck

44
Q

Which benzo was used as a muscle relaxant but is now discontinued?

A

tetrazepam

45
Q

What are the drug interactions with benzos? why?(6)

A
  • CNS depressive effect is greater
  • alcohol
  • barbiturates
  • opiates
  • can result in hypoventillation and coma
46
Q

Benzo contraindications? (4)

A 
-myasthenia gravis
Cautioned with:
-chronic respiratory disease (COPD)
-liver disease
-pregnancy/breastfeeding
47
Q

Benzos are dangerous when…. (3)

A
  • adminsitered IV at high doses
  • with other CNS depressants (ex. opiates)
  • (cautioned)with chronic respiratory disease
48
Q

somnolence, stupor and coma with benzos… (3)

A
  • side effect in elderly
  • can improve in a few days
  • worse if another CNS depressant is ingested
49
Q

What drug can be taken in high doses with the intention to commit suicide? what are the effect? (3)

A

benzodiazepines

  • hypoventilation
  • coma
50
Q

What is ataxia

A

lack of voluntary coordination of muscle movements

51
Q

When does addiction occur with benzos?

A

6 months

52
Q

When does benzo withdrawl occur? (2)

A
  • using longer than 6 months

- when stopping treatment

53
Q

Which drugs cause bezno withdrawl?

A

medium-short half life

54
Q

What are benzo withdrawl symptoms? (8)

A 
Mild: insomnia and anxiety
Sometimes:
-irritability
-sweating
-tremor
-muscle stiffness
-seizures
-psychosis
55
Q

How do we prevent benzo addiction? (3)

A
  • lowest dose
  • shortest time (no more than 4-6 months)
  • dont stop treatment abruptly (reduce over 2 weeks)
56
Q

can benzos be used during pregnancy and/or pregnancy?

A

no

57
Q

What are the anxiolytic drugs?

A
  • benzos

- buspirone

58
Q

What effect does buspirone have?

A

sedative

hypnotic

59
Q

When is buspirone the 1st choice of treatment? (3)

A

when benzodiazpine:

  • is contraindicated
  • has too many adverse effects
  • no addiction
60
Q

Why is buspirone the 2nd choice of treatment? (2)

A

because benzo’s are:

  • faster
  • stronger
61
Q

Which drugs are hypnotics? (5)

A
  • Barbiturates (not used as hypnotics anymore)
  • Benzodiazepines.
  • Chlormethiazole: hypnotic, sedative, anticonvulsant.
  • Doxilamine (antihistamine H1)

Hypnotic, sedative, muscle relaxant, anticonvulsant:

  • Zolpidem
  • Zopiclone
62
Q

The group of drugs most commonly used as HYPNOTICS are

A

BENZODIAZEPINES (BZD)

-zepam or zolam

Pharm (14 decks)

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