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Phar 507 > Pharmacology of anxiolytic drugs > Flashcards

Pharmacology of anxiolytic drugs Flashcards

1
Q

What are the type of anxiety disorders

A

generalized anxiety disorder, Obsessive compulsive disorder,

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2
Q

What is the development of anxiety

A

Pre-existing sensitivity (gene plus environment) -> learning of fear (index traumatic event) -> consolidation of fear (hours to days following event) -> expression of anxiety (memories, flashbacks, nightmares, avoidance, startle)

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3
Q

What is the organ in the brain that drives a short term fear response and fear learning

A

Amygdala (site of BZD action)

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4
Q

T/F: Smell and touch bypass the thalamus go straight to amygdala inducing a much stronger stress response then sound and visual stimuli

A

True

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5
Q

What part of the brain causes the symptoms of fear and anxiety, symptoms

A

Locus ceruleus/ rapid hearbeat, increased blood pressure, sweating, pupil dilation

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6
Q

What is the organ in the brain that drives a long term fear response

A

Bed nucleus of the stria terminalis (site of BZD)

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7
Q

T/F: Memory consolidation happens in the hippocampus

A

True

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8
Q

What is fear extinction, what are the relevant structures involved

A

Decrease in fear responses during repeated presentations of the conditioned stimuli without the unconditioned stimulus reinforcement/ amygdala, hippocampus and cortex

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9
Q

T/F: A sedative calms a patient while a hypnotic drug produces drowsiness

A

True

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10
Q

What is the real approval time frame for BZDs

A

2-4 weeks

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11
Q

T/F: All BZDs have the same efficacy but there is a difference pharmcokinetics that influence the drug chosen

A

True

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12
Q

T/F: BZDs can cause tolerance to sedation effects BUT NOT Anxiety effects

A

True

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13
Q

What occurs when a GABA receptor is activated

A

Diffusion of chloride ions across the cell membrane

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14
Q

Where does GABA bind, where does BZDs bind

A

between alpha-beta subunit, bind at the alpha-gamma interface

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15
Q

T/F: BZDs are GABA agonists

A

False: BZDs are allosteric modulators that increased the affinity of GABA to the receptor

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16
Q

What is a competitive BZD antagonist

A

Flumazenil

17
Q

T/F: BZDs are both allosteric modulators BUT BARBITURATES can activate Cl channel opening in the ABSENSE of GABA

A

TRUE

18
Q

T/F: Barbiturates increase the open time of GABA channels

A

True

19
Q

How come BZDs are not anesthetics

A

Patients can still feel pain

20
Q

Why do BZDs have abuse potential

A

DOPAMINE is dumped by ventral tegmental area into the Nucleus accumbens, Dopamine causes medium spiny neurons to inhibit GABA from inhibiting dopamine release to cause the cycle to continue

21
Q

What effects of BZDs causes tolerance

A

Sedation/hypnotic (greater with short half life BZDs) and Anticonvulsant/muscle relaxant

22
Q

What effects of BZDs do not cause tolerance

A

Anxiolytic, dependence potential (greater potential for dependance in short half life BZDs), amnesia

23
Q

T/F: Chronic use of BZDs is associated with dementia even after discontinuation

A

True

24
Q

What are the short acting BZDs

A

Midazolam and Triazolam

25
Q

What are the intermediate acting BZDs

A

Alprazolam, Clonazepam, Estazolam, Lorazepam, Oxazepam, Temezepam

26
Q

What are the long acting BZDs

A

Chlordiazepoxide, Clorazepate, Diazepam, Flurazepam, Quazepam

27
Q

Which BZDs can be given IM

A

Chlordiazepoxide (L), Diazepam (L), Lorazepam (I), Midazolam (S)

28
Q

What BZDs can be given IV

A

Chlordiazepoxide (L), Diazepam (L), Lorazepam (I), Midazolam (S)

29
Q

What is the only BZD that can be given rectally

A

Diazepam

30
Q

What are withdrawl effects of BZDs

A

anxiety, increased sensitivity to light and sound, muscle cramps, myclonic jerks, sleep disturbances, Seizures and delirium (high dose)

31
Q

T/F: Drug accumulation is most likely to happen in BZDs that are long acting

A

True

32
Q

What is the anti-anxiety MOA of busprione, anti depressant property

A

Full agonist at the pre-synaptic 5-HT1 receptors inhibiting 5-HT synthesis and firing, partial agonist at post synaptic 5-HT1A

33
Q

What are the benefits of buspirone over BZDs

A

Nonwithdrawl syndrome, no tolerance to anxiolytics effects

34
Q

T/F: Just like BZDs there is no evidence of tolerance to anxiolytic effects when using buspirione

A

True

35
Q

Which hypertensive drug decreases norephinephrine therefore decreasing the anxiety response

A

Clonidine

Phar 507 (33 decks)

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