Non-benzo Anxiolytics And Hypnotics Flashcards
Barbiturates
Phenobarbital Cyclobarbital Amobarbital Thiopental Thiobutobarbital Methohexital
Action of barbiturates
Facilitate the action of GABA by increasing duration of channel opening. They may also directly activate the chloride channel.
Adverse effects of barbiturates
- Low safety margin
- no antagonist
- dependence and tolerance
- enzyme induction
- drug interaction
- drowsiness
- impaired concentration
- nausea
- dizziness
- overdose may lead to death
Long acting barbiturates
Phenobarbital
Used as antiepeptics or iv anesthesia
Medium and short acting barbiturates
Cyclobarbital and amobarbital
Ultra short acting barbiturates
Thiopental
Thiobutobarbital
Methohexital
Withdrawn barbiturate
Thalidomide
Teratogenic effects
Non-benzodiazepines hypnotics
Z-compounds
- (es)zopiclone
- zolpidem
- zaleplone
(Es)zopiclone (imovane)
Effective for insomnia
Adverse effects
Anxiety, dry mouth, headache, peripheral edema, somnolent, unpleasant taste
Zaleplone
Treat insomnia in patients who has trouble falling asleep, not maintaining sleep (short half life)
Zolpidem
Insomnia
Adverse effects
- nightmares, agitation, anterograde amnesia, headache, gi disturbances, dizziness, daytime drowsiness
Non-benzodiazepines anxiolytics
SSRI
Buspirone
Buspirone
Partial agonist at 5-HT1a receptor. Does not cause dependence or sedation.
Anxiolytic
Slow onset (1-3 weeks) Used in GAD, but not panic disorders
If benzodiazepines are ineffective, buspirone won’t work either
MT1 and MT2 agonist
Agonist of melatonin receptor (suprachiasmatic nuclei) involved in controlling circadian rhythm.
Used for insomnia - no rebound or abuse
Eg;
Ramelteon (sporanox)
Tasimelteon
Ramelteon
MT Agonist
Unspecific adverse effects; dizziness, fatigue, headache
Suicide in pre-existing depression
