lecture 61 Flashcards
yang - pharmacology of anxiolytics and sedative/hypnotics
what is the GABAb receptor known as?
metabatropic receptor
agonists – baclofen, GHB
antagonist – phaclofen, saclofen, and 2-hydroxysaclofen
what are the concerns related to GHB?
there is no antagonist for it so concerned about supportive treatment
what is ramelteon (rozerem)?
a melatonin agonist
no abuse, withdrawal, or dependency
acts on the suprachiasmastic nucelus (SCN)
what is the suprachiasmastic nucleus (SCN)?
serves as the master clock by regulating circadian rhythms
what is tasimelteon (hetlioz)?
melatonin agonist
orphan product registration
what is suvorexant (belsomra)?
orexin receptor antagonist on the hypothalamus
reduces rewarding stimuli (through DA release) by modulating the projections between the VTA and the nucleus accumbens
what antihistamine OTC drugs have been used as sedative-hypnotics in history?
diphenhydramine
doxylamine
pyrilamine
what drugs can induce anxiety?
cocaine
beta agonists
psychostimulants (caffeine)
corticosteroids
what diseases can induce anxiety?
CHF
COPD
diagnosis of terminal disease
what agents can induce anxiety from withdrawal of them?
antidepressants
anxiolytics
drugs of abuse
cell phone/social media
where does NE project to?
amygdala
what is glutamic acid decarboxylase (GAD)?
enzyme that converts glutamate to GABA in teh CNS
what are the benefits of using benzos for drug treatment?
quick acting and effective
what is buspirone (Buspar)?
partial agonist on brain 5HT1a receptors
adaptive response (with longer onset of action than benzo)
low abuse potential
when is buspirone used?
GAD, social anxiety, or comorbid depression
adj. use with OCD/PTSD
not good for panic disorder (benzos – much faster)
what BB can be used for anxiety?
propranolol
what is important to note about propranolol in accordance with anxiety?
may need test dose initial
decreases peripheral symptoms of anxiety like sweating
what are some miscelleanous anxiolytics?
hydroxyzine
clonidine
serotonin receptor antagonist (zofran)
GABA uptake blocker (tiagabine)
partial benzo receptor agonists
glutamatergic agents
