sedatives + antianxiety Flashcards
what do sedatives do?
depress CNS function
what are sedatives used for?
anxiety and insomnia
many of the same drugs are used for anxiety and insomnia. whats the difference?
dosage!
lower dose= anxiety
higher doses= insomnia
what is the drug of choice for hypnotics?
benzos
benzo prototype
triazolam (halcion)
other benzos to know (4)
lorazepam (Ativan)
Diazepam (valium)
alprazolam (Xanax)
Midazolam (Versed)
MOA of benzos
potentiate GABA, make endogenous gaba go further!
what schedule are benzos?
schedule 4
what is triazolam (benzo) primarily used for?
sleep! increases total amount of sleep time. tolerance develops slowly, no rebound if you stop.
benzo AE on CNS
sedation, confusion, anterograde amnesia, drowsiness, sleep-driving
benzo AE on CV
oral- little to no effect
IV- profound HYPOTENSION and CARDIAC ARREST
benzo AE on respiratory
oral– little to no effect
IV- significant resp. depression if taken in combo with other CNS depressants
can worsen airway obstruction in OSA and COPD
benzos and pregnancy
NO WAY!
physical dependency and benzos
wean slowly
withdrawal and benzos
if on high doses can be severe!
symptoms: panic, paranoia, delirium, HTN, muscle twitches, convulsions
antidote for benzos
flumazenil (romazicon)
how to admin flumazenil
admin over 15 seconds, repeat Q min, effects last an hour.
won’t help respiratory effects but will help CNS which can help RR
benzo-like drugs MOA
act as agonists @ the benzo receptor site on the GABA receptor- chloride channel
benzo-like prototype
zolpidem (ambien)
zolpidem characteristics
good for falling asleep, ER for staying asleep
SE of benzo-like (zolpidem)
sleep driving
daytime drowsiness
no physical dependence/tolerance but do have to wean off
drugs to treat anxiety (4)
SSRI
Benzodiazepines
buspirone (buspar)
antihistamine (hydroxyzine)
buspirone characteristics
NOT a CNS depressant NO abuse potential NO suicide risk No increased CNS effects with other CNS depressants NOT for PRN use (takes weeks to use) NO grapefruit juice
Hydroxyzine characteristics
can be taken as scheduled or PRN
no withdrawal, not a controlled substance
also used for insomnia (sedation SE)
SE of hydroxyzine
dry mouth, constipation, confusion, dizziness, headache, fatigue, and with long term use– QT prolongation.
