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Pharmacology (MSK + Neuroscience) > Drugs for Anxiety (Anxiolytics) > Flashcards

Drugs for Anxiety (Anxiolytics) Flashcards

1
Q

State the psychological components of anxiety (4)

A
  1. worry, nervousness, uneasiness
  2. arousal
  3. lack of concentration
  4. insomnia
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2
Q

State the physical components of anxiety (5)

A
  1. tachycardia
  2. sob
  3. nausea
  4. gastric acid hypersecretion
  5. trembling
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3
Q

GENERALISED ANXIETY DISORDER (GAD)
- ____, ____ worry over everyday matters
- interferes with daily functioning
- has both psychological and physical symptoms
- diagnosed when present for > ____ months
- most common cause of disability in the workplace

A

GENERALISED ANXIETY DISORDER (GAD)
- EXCESSIVE, UNCONTROLLABLE worry over everyday matters
- interferes with daily functioning
- has both psychological and physical symptoms
- diagnosed when present for > 6 months
- most common cause of disability in the workplace

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4
Q

State some other anxiety and fear disorders (4)

A
  1. ptsd - post traumatic stress disorders
  2. phobias
  3. panic disorder
  4. ocd - obsessive compulsive disorder
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5
Q

State the 3 functions of CNS depressants to treat anxiety disorders

State the level of dosage required for each function to be effective.

A
  1. sedative –> causes sedation and relaxation (use at low dose)
  2. hypnotic –> induces drowsiness and sleep and can have amnestic effects (use at high dose)
  3. anxiolytic –> reduces anxiety (use at low dose)

at very high doses, CNS depressants can cauase anaesthesia required for surgery

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6
Q

State the 2 classes of drugs used in treatment of anxiety disorders

A
  1. benzodiazepines
  2. non-benzodiazepines (zodipem, busiprone, barbiturates, hydroxyzine, propanolol)
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7
Q

State the MOA of benzodiazepines in treatment of anxiety disorders

A

Benzodiazepines bind to allosteric site on GABA –> potentiates influx of Cl- ions by increasing frequency of GABA-induced channel opening –> hyperpolarisation of cell –> decreased AP firing

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8
Q

State the names of the short acting, intermediate acting and long acting benzodiazepines.

A

Short acting:
1. midazolam
2. triazolam

Intermediate acting:
1. alprazolam (xanax)
2. clonazolam
3. lorazepam
4. oxazepam
5. temazepam

Long acting:
1. chlordiazepoxixde
2. diazepam (valium)
3. flurazepam

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9
Q

Is lorazepam a short-acting, intermediate-acting or long-acting benzodiazepine?

A

intermediate acting

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10
Q

Is temazepam a short-acting, intermediate-acting or long-acting benzodiazepine?

A

intermediate-acting

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11
Q

Is diazepam a short-acting, intermediate-acting or long-acting benzodiazepine?

A

long-acting

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12
Q

Is alprazolam a short-acting, intermediate-acting or long-acting benzodiazepine?

A

intermediate-acting

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13
Q

Is triazolam a short-acting, intermediate-acting or long-acting benzodiazepine?

A

short-acting

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14
Q

Is valium a short-acting, intermediate-acting or long-acting benzodiazepine?

A

long-acting

valium = diazepam

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15
Q

State a clinical scenario where short-acting and long-acting drugs are each used.

A

short-acting –> medical procedures/surgery since there is rapid onset and short half life which allows for faster recovery

long-acting –> chronic conditions

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16
Q

State the adverse effects of benzodiazepines.

A
  1. acute toxicity/overdose –> leading to severe respiratory depression (treat with flumazenil, benzodiazepine antagonsit)
  2. drowsiness, confusion, amnesia
  3. impaired muscle coordination –> impairs manual skills
  4. tolerance and dependency –> has abuse potential
17
Q

State the intermediate acting benzodiazepines

A

A CLOT:
A = Alprazolam
C = Clonazepam
L = Lorazepam
O = Oxazepam
T = Temazepam

18
Q

State the short-acting and long-acting benzodiazepines

A

Short-acting (MT)
M = Midazolam
T = Triazolam

Long-acting (CDF)
C = Chlordiazepoxide
D = Diazepam
F = Flurazepam

19
Q

State the examples of non-benzodiazepines.

A
  1. zopidem
  2. busiprone
  3. barbiturates
  4. pregabalin
  5. hydroxyzine
  6. propanolol
20
Q

State the MOA of zopidem

State the benefits and disadvantages of zopidem

A

MOA = potentiates GABA-A mediated Cl- currents at the same site as benzodiazepines

benefit - good hypnotic effect - can treat insomnia
disadvantages - not effetive as anxiolytics

21
Q

State the MOA of busiprone.

State the benefits and disadvantages of busiprone

A

MOA = Serotonin 5-HT2a receptor partial agonist + binds to dopamine R

benefit = treats GAD since anxiolytic effect takes 1-2 weeks
disadvantages = lacks anticonvulsant effect + lacks muscle relaxant properties

22
Q

Name some barbiturates (long-acting, short-acting and very-short acting)

State the MOA of barbiturates.

State the benefits and disadvantages of barbiturates.

A

Long-acting:
- anticonvulsants - phenobarbital
Short-acting:
- sedative and hypnotic - pentobarbital + amobarbital
Ultra-short acting:
- IV indution anaesthesia - thiopental

MOA = potentiates GABA-a mediated Cl- currents at site distinct from benzodiazepines

benefits = at anaesthetic site, barbiturates can directly open CL- channels and block Na+ channels
disadvantages = sedative-hypnotic replaced by benzodiazepines due to tendency to develop tolerance and dependece + severe withdrawal symptoms + flumazenil not effective for treating barbiturate overdose

23
Q

State the MOA of pregabalin.
​
State the benefits and disadvantages of pregabalin.

A

MOA = GABA analogue that acts on voltage gated Ca2+ channels –> increases synaptic GABA –> GABA-R mediated Cl- currents resulting in hyperpolarisation –> decreased AP firing

benefits = treats GAD + has anticonvulsant effects
disadvantages = worsens suicidal thoughts

24
Q

State the MOA of propanolol.

State the benefits and disadvantages of propanolol.

A

MOA = beta-adrenergic receptor antagonist

benefits = treats performance anxiety and social phobia + less physical symptoms associated with adrenergic activation
disadvantages = contraindicated in asthma and heart conditions

25
Q

State the contraindication for pregabalin

A

patients with suicidal ideation / previous suicidal attempts

26
Q

State the contraindication for propanolol

A

patients with asthma + patients with heart conditions

27
Q

State the MOA of hydroxyzine

State the benefits of hyroxyzine

A

MOA = first generation antihistamine with activities on serotonergic and alpha-adrenergic receptors + serotonin 5-HT2 receptor antagonism

benefits = low addictive potential + antihistamine properties helps treat itch

Pharmacology (MSK + Neuroscience) (7 decks)

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