Drugs For Anxiety And Insomnia

Question 1

Limbic system (Anxiety)

Answer 1

Part of brain involved with anxiety (middle, old brain)

Controls emotion, learning, memory

Question 2

Types of Anxiety

Answer 2

• Situational-stressful environment
• Generalized Anxiety disorder(GAD)- >6months, most common
• panic disorder-immediate terror, last <10 minutes

Question 3

Types of Anxiety cont’d

Answer 3

• Phobias- large fear of situationa/objects
• social anxiety- fear of being judged
• OCD- reoccurring thoughts/behavior
• PTSD- traumatic event develops severe situational anxiety

Question 4

Hypothalamus 4Fs (anxiety)

Answer 4

*Unconscious responses to stress/environment

• fight or flight
• food
• sexual function

Question 5

Reticular Formation (Anxiety)

Answer 5

Stimulation:inc inalertness and arousal
inhibition: drowsiness/sleep

*may be involved with ADHD

Question 6

Anxiety Management

Answer 6

• remove stress
• use of anxiolytics- tx symptoms
• CNS depressants- benzos and barbs
• anti hypertensive agents
• antidysrhythmics-normalize heart func.

Question 7

Anxiety Management cont’d

Answer 7

SSRIs
SNRIs
(Go in depth later)

Question 8

Barbiturates (Barbs) Moa

Answer 8

CNS depressant=GABA system agonist

Rarely used now (low TI) and must taper off to avoid seizures

*can trigger malignant hyperthermia

Question 9

Barbiturates drugs

Answer 9

Pentobarbital (nembutal)

Phenobarbital (luminal)

Question 10

Antidepressants (SSRI) MoA

Answer 10

Inhibit reuptake(removal) of 5HT from the synapse -> longer time to bind to receptors (5HT agonist)

*thoughts of suicide at beginning of tx

Question 11

SSRI Drugs

Answer 11

Citalopram (celexa)
Escitalopram (lexapro)
Fluoxetine (prozac)
Paroxetine (paxil)
Sertraline (zoloft)

Question 12

Antidepressants (SnRI) moa

Answer 12

Serotonin and NE reuptake inhibitors->longer time to bind to receptors

Aka 5HT and NE agonists

Question 13

SNRI Drugs

Answer 13

Duloxetine (cymbalta)
Trazodone (desyrel,oleptro)
Venlafaxine(effexor)

Question 14

Antidepressants (tricyclic antidepressant (TCA) moa/drugs

Answer 14

Block reuptake of 5HT and NE

No alcohol amd limited uses

Amitryptyline (elavil)

Question 15

Antidepressant(MAOI) Moa/drugs

Answer 15

Inhibits degradation of DA and NE

*Tyramine buildup can cause hypertensive crisis due to large amts of NE causing vasoconstriction

Phenelzine(nardil)

Question 16

Benzodiazepines (benzos) MoA

Answer 16

GABA receptor agonist

*CNS depressant, sedative, and much safer than barbs

Do not mix with alcohol

Question 17

Benzos drugs

Answer 17

Diazepam (valium)
Lorazepam (atvian)
Alprazolam(xanax)

Question 18

Sleep Disorders

Answer 18

Insomnia-cant fall asleep
Narcolepsy -daytime drowsiness
Sleep apnea-ceasing to breathe during sleep
Long term insomnia -caused by ptsd, depression, injury
Rebound insomnia-quit sleep pills

Question 19

NREM vs REM

Answer 19

NREM-repair body during

REM-emotional stabilization during

Question 20

Sleep- Zolpidem(ambian) moa

Answer 20

Potentiates GABA -CNS depressant

Schedule IV and not to be used routinely, has fast onset of action

*sedative-hypnotic= not natural sleep

Question 21

Sleep- Zaleplon (Sonata) moa

Answer 21

Hypnotic cns depressant-gaba agonist

Tx: sleep maintenance insomnia but not for longterm

Question 22

Sleep- Ramelton (rozerem) moa

Answer 22

Melatonin receptor (+) MT1 and 2

Long term use OK

Question 23

Sleep- Suvorexant (Belsomra)moa

Answer 23

Blocks action of orexin (involved in wakefulness)

No alcohol

Question 24

Sleep Drugs

Answer 24

Zolpidem(ambian)
Zaleplon (Sonata)
Ramelton (rozerem)
Suvorexant (Belsomra)

Question 25

Narcolepsy Drugs

Answer 25

Madafinil (provigil)

Prazoson (MiniPress)

Question 26

Madafinil (provigil) Moa

Answer 26

DAT (-) to keep Dopamine in synapse

Inc release of orexin and histamine

Question 27

Prazoson (MiniPress) MOA

Answer 27

Alpha 1 (-) that crosses BBB and blocks stress response

Tx:nightmares and insomnia