Hypnotics and anxiolytics 2

Question 1

Benzodiazepines used as hypnotics include nitrazepam and flurazepam. How long do their action last for and what are the disadvantages of using these drugs?

Answer 1

1) Prolonged action and may give rise to residual effects on the following day
2) repeated doses tend to be cumulative

Question 2

list the short-acting benzodiazepines and outline the advantages and disadvantages of using these drugs

Answer 2

1) Loprazolam, lormetazepam, and temazepam
2) have little or no hangover effect
3) Withdrawal phenomena are more common with the short-acting benzodiazepines

Question 3

If insomnia is associated with daytime anxiety which benzodiazepine should be prescribed and why?

Answer 3

The use of a long-acting benzodiazepine anxiolytic such as diazepam given as a single dose at night may effectively treat both symptoms

Question 4

Zolpidem and zopiclone are non-benzodiazepine hypnotics. what are the disadvantages of using these drugs and how long is their onset of action?

Answer 4

1) They are not licensed for long-term use; dependence has been reported in patients
2) short duration of action

Question 5

Promethazine is on sale to the public for occasional insomnia. what are the side effects associated with using sedative antihistamines?

Answer 5

1) prolonged duration of action can often cause drowsiness the following day. may diminish after a few days
2) SE include: Headache, psychomotor impairment and antimuscarinic effects

Question 6

Explain why alcohol is a poor hypnotic

Answer 6

1) Diuretic action interferes with sleep during the night

2) Disturbs sleep patterns, and so can worsen sleep disorders

Question 7

Melatonin is a pineal hormone, who is it licenced for use in?

Answer 7

it is licensed for the short-term treatment of insomnia in adults over 55 years

Question 8

Benzodiazepine anxiolytics can be effective in alleviating anxiety states. Which conditions should they not normally be prescribed in?

Answer 8

1) stress-related symptoms, unhappiness, or minor physical disease
2) Not appropriate for treating depression or chronic psychosis

Question 9

Outline the use of beta blockers to treat anxiety

Answer 9

1) Do not affect psychological symptoms of anxiety e.g. worry, tension, fear and also muscle tension
2) But they do reduce autonomic symptoms, such as palpitation and tremor. Therefore useful in those with mainly somatic symptoms, which may as a result, prevent the onset of worry and fear.

Question 10

Benzodiazepines are indicated for the short-term relief of severe anxiety. list the benzodiazepines that have sustained action

Answer 10

Diazepam, alprazolam, chlordiazepoxide and clobazam

Question 11

which 2 benzodiazepines may be preferred in patients with hepatic impairment. what are the disadvantages of using these drugs?

Answer 11

1) Shorter-acting compounds such as lorazepam and oxazepam

2) carry a greater risk of withdrawal symptoms

Question 12

The very short-acting barbiturate thiopental sodium is used in what?

Answer 12

anaesthesia