Benzodiazepines, Barbiturates, Buspirone Flashcards
BZD MOA
GABAa receptor stimulation between the alpha and gamma subunit
Alpha-1 GABA isoform effects
Sedation, amnesia, ataxia
Alpha-2 GABA isoform effects
Anxiety and muscle relaxing
Alpha-3 GABA isoform effects
Memory and learning
Short acting BZDs
Alprazolam
Midazolam
Triazolam
Intermediate BZDs
Lorazepam
Temazepam
Long acting BZDs
Diazepam
Flurazepam
Which BZD is used for muscle relaxation?
Diazepam
Which BZD is a long-acting used for insomnia?
Flurazepam
Which BZDs have the most intense rebound?
Short acting BZDs
AMT
Which BZDs have the mildest rebound, but the longest lasting?
Long acting BZDs
Diazepam, Flurazepam
Which BZDs have very active metabolites?
Long acting BZDs
Diazepam, Flurazepam
Which BZDs have the weakest metabolites?
Short acting BZDs
AMT
What drug is used to treat BZD overdose at BZD receptor (also includes non-BZDs)?
Flumazenil
Flumazenil MOA
Competitive antagonist of the GABAa receptor
What is the main risk of Flumazenil?
Seizures
What increases the likelihood of side effects with Flumazenil?
If patient is on BZDs and TCAs
What class of drugs is best for acute anxiety and panic attacks?
BZDs
Which class(es) of drugs is best for chronic anxiety and long-term use?
TCAs and Anti-depressants
Which effects develop tolerance first to BZDs?
Anti-seizure and hypnotics
What is the most common side effect of BZDs?
Drowsiness/sedation
What are the contraindications of BZDs?
Elderly (anterograde amnesia)
Pregnancy
What is something you would not expect in an overdose toxicity with BZDs?
Normal vital signs
What is the main use for phenobarbitol?
Seizures
What is the main side effect of Phenobarbitol?
CNS and respiratory depression = fatal
Which drug results in alkalinization of the urine (which enhances elimination)?
Phenobarbitol
What are the first symptoms to develop tolerance to phenolbarbitol?
Sedation/hypnotic effect
What symptoms do not develop tolerance to phenobarbitol?
Respiratory depression
Anti-seizure
What is a concern of abrupt withdrawal of phenobarbital on day 2?
Deilirum, seizures, death
What is the main problem with using Buspirone as treatment for anxiety?
Anti-anxiety effect takes 3-4 weeks
What are the benefits of using Buspirone for treatment?
Little abuse, no rebound anxiety, no dependence, no sedation, no euphoria, no effect on motor skills, safe for pregnancy