Pharm 4 Anxiolytics

Question 1

Goal of anxiety Tx

Answer 1

Anxiolytics w/o sedation

Question 2

Tx of choice for long term anxiety

Answer 2

SSRI

Question 3

Benzodiazepines v Barbiturates

Answer 3

Benzo much safer

Benzo doesn’t induce liver enzymes

Question 4

Benzo MOA

Answer 4

Binds GABA (Cl-) channel, allosteric modulation increase GABA binding affinity

5 subunit channel leads to many different drugs

Question 5

Anxiolytic subunits

Answer 5

A2,3 (amygdala)

Question 6

Sedative subunits

Answer 6

A1,5 (attention, arousal)

Question 7

Benzo metabolism

Answer 7

Liver conjugation- no grapefruit juice, erythromycin

Question 8

Benzo use for medical procedures

Answer 8

Amnesia adjuvant, NOT anesthetic

Question 9

Benzo overdose Tx

Answer 9

Flumazenil (antagonist)

Question 10

Z drug with shortest half life

Answer 10

Zaleplon (sonata)

Question 11

Z drug with possible residual morning effects

Answer 11

Zolpidem (ambien)

Question 12

Z drug for long term use

Answer 12

Eszopiclone (lunesta)

Question 13

Barbiturate MOA

Answer 13

Low dose - facilitate GABA binding

High dose - directly open channel

Question 14

Barbiturate anesthesia adjunct

Answer 14

Thiopental

Question 15

Barbiturate for anticonvulsion

Answer 15

Phenobarbital (less sedation)

Question 16

Melatonin agonist

Answer 16

Ramelteon

Question 17

Ramelteon MOA

Answer 17

Melatonin receptors, NOT GABA

Question 18

Ramelteon indication

Answer 18

Sleep onset insomnia

Question 19

Orexin drug

Answer 19

Antagonist - orexin promotes wakefulness

Question 20

Antihistamine SE

Answer 20

Daytime sleepiness

Question 21

Trazadone

Answer 21

Promote sleep at low doses

Antidepressant at high doses