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Flashcards in Antianxiety Medications Deck (24)
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1

What are anti-anxiety medications also called?

  • Sedative hyponotics
  • Minor tranquilizers

2

What are among the most widely used drugs in medicine?

Benzodiazepines

3

What accounts for 75% of 100 million prescriptions written for sedatives/tranquilizers?

  • diazepam (Valium) and
  • chlordiazepoxide (Librium

4

What are the popular benzodiazepams?

  • diazepam (Valium)
  • lorazepam (Ativan)
  • alprazolam (Xanax)
  • midazolam (Versed) = "dazzle"

5

Are benzo's addictive?

Yes - highly! Schedule IV/V opiates 

6

What 3 effects do Benzodiazepines produce?

  1. Effects on behavior
  2. Anticonvulsant effects
  3. Muscle relaxation

7

What do Benzo's do at low/high doses regarding behavior?

  • Low - anxiety reduction
  • High - drowsiness/depression 

8

What two anticonvulsants can be used to prevent and arrest local anesthetic-induced seizures in dentistry?

V.V. = no seizure

  • diazepam (Valium) - IV 5mg/min
  • midazolam (Versed) - IV 1mg/min

9

Which Benzos are the most potent muscle relaxers?

  • diazepam (Valium)
  • chlordiazepoxide (Librium) 

10

How do benzo's cause muscle relaxation?

They depress the motor nerve and muscle function 

11

What is the mechanism of action of BDZ's?

  • They enhance the inhibitory effect on GABA on neuronal excitability
    • Remember GABA = inhibitory and decreases excitation on brain
  • Causes hyperpolarization and neuronal stabilization

12

What are the binding characteristics of Benzodiazepines to their receptor sites?

  • Rapid
  • Reversible
  • Stereospecific
  • Saturable

13

How long are most benzo's half lifes? And what are they metabolized into?

  • Most have very long half-lives
  • Most are metabolized to active compounds

14

What benzodiazepine is metabolized into  inactive compounds, which makes it a great choice for dentistry?

lorazepam (Ativan)

15

What are the uses for benzos in medicine?

  • Anxiety relief
  • Skeletal muscle relaxation
  • Hypnotic to treat insomnia
  • Treatment of alcohol withdrawal
  • Pre-operative medication

16

What are the uses of Benzo's in dentistry?

  • Reduce pre-operative anxiety
    • Valium, Ativan, Xanax, Halcion
  • IV sedative and amnesiac
  • Emergency intervention for seizures

17

What are some adverse effects of benzodiazepines?

  • CNS depression
  • Xerostomia
  • Abuse & addiction
  • Additive effects with other CNS depressants, especially alcohol

18

What do you do when a benzodiazepine has to be given to a patient that is already taking opiates?

Reduce dose of opiates by 1/3 of normal dose 

19

What is a very dangerous drug interaction of benzodiazepines?

Alcochol - results in severe CNS depression --> respiratory depression

The long half-life of benzo's mean the risk persists for days after dose (20-50 hours) 

20

What is a miscellaneous anti-anxiety agent?

buspirone (BuSpar)

21

What drugs do you avoid when taking BuSpar?

The red flag drugs:

  • ciprofloxacin
  • clarithromycin
  • erythromycin
  • doxycycline
  • systemic antifungals 

22

What drugs are known to cause xerostomia?

  • Antidepressants & anti-anxiety meds

23

With what drugs do you have to be cautious with epinephrine?

Tricyclics & MAOIs

24

What's known to cause bruxism?

SSRI's