Anxiolytic and hypnotic drugs

Question 1

chloradiazepoxide 
lorazepam
midaxolam 
temazepam 
are all examples of

Answer 1

Benzodiazepines

Question 2

Benzodiazepines have a …..effect?

Answer 2

Anxiolytic and hypnotic

Question 3

Barbiturates have a …..effect?

Answer 3

Anxiolytic and hypnotic

Question 4

Busipirone is a…

Answer 4

5-HT1a agonist

Question 5

propranolol is a

Answer 5

B antagonist

Question 6

escitalopram is a

Answer 6

SSRI

Question 7

What is the benefit of using B antagonists for anxiety?

Answer 7

They reduce the physical symptoms and reduce feedback loop for continued anxiety
- no impact on psychological experience

Question 8

How does lorazepam impact sleep?

Answer 8

A benzo

• reduced the time taken to fall asleep and increases duration
• less REM sleep

Question 9

Side effect of benzos?

Answer 9

Tolerance develops

stop Benzol -rebound increase in REM sleep

Question 10

What impact to Benzes have on muscle?

Answer 10

Reduce muscle tone and coordination

Question 11

T or F Benzo’s have anti-convulsant activity?

Answer 11

True

Question 12

Anterograde amnesia is associated with what drug?

Answer 12

Benzodiazepines

• endoscopy
• dental procedures
• date rape drug

Question 13

MOA of benzodiazepines

Answer 13

Enhance GABA activity at GABAa receptors
bind to an accessory site on the receptor, induces conformational change
to enhance GABA binding + activity

Question 14

How does GABA cause inhibition

Answer 14

Increases Cl- by increasing the frequency of channel openings

Question 15

MOA of benzodiazepine inverse agonists e.g. B carbolines

Answer 15

Bind to receptor at BZ accessory site and produce increased anxiety and convulsions

Question 16

What do BZ antagonists do?

Answer 16

Competively inhibit the action of BZ ( agonists ) and BZ inverse agonists
They bind passively, no direct effect, they just block the others from acting

Question 17

Where do BZs bind, accumulate and how are they metabolised?

Answer 17

bind to plasma proteins
accumulate in fat
excreted as glucuronide conjugates
Noradazepam is a long-lasting, pharm active metabolite of some BZs

Question 18

What consideration must be made when prescribing BZs to elderly patients?

Answer 18

The half life is increased in elderly

Question 19

Which type of BZ is used for sleep disorders and anxiety?

Answer 19

Short and medium

lorazepam ad alprazolam

Question 20

What are the uses and give an example of a long acting BZ?

Answer 20

Used for anxiety and epilepsy
not hypnosis
e.g. diazepam

Question 21

T or F triazolam is used for anxiety?

Answer 21

F
it is ultra short < 6hrs
only hypnotic

Question 22

T or F alprazolam is used for anxiety?

Answer 22

True 24hrs medium BZ

Question 23

What can be used to reverse the acute toxicity caused by BZs?
How does the acute toxicity present?

Answer 23

Flumazenil

respiratory depression esp when combined with alcohol

Question 24

What type of drug is zolpidem

Answer 24

a non-BZ hypnotic

Question 25

What are the advantages of using zolpidem vs BZ

Answer 25

No hanger rapid onset of action not myorelaxant, anticonvulsant or anxyiolytic

Question 26

Buspirone, isapirone and gepirone are all examples of

Answer 26

5-HT1a receptor agonists

Question 27

Use of 5-HT1a receptor agonists ?

Answer 27

Anxiolytic | takes days or weeks

Question 28

Which is not a side effect of 5-HT1a receptor agonists ? - Dizziness - headache - sedation - loss of balance - loss of coordination - withdrawal - nausea - addiction

Answer 28

Sedation is not a side effect of 5-HT1a receptor agonists addiction not listed

Question 29

Pentobarbital ......the actions of GABA

Answer 29

Enhances the actions of GABA

Question 30

T or F | tolerance and dependence are side effects of barbiturates

Answer 30

True

Question 31

What is the first line therapy for anxiety disorders | give examples

Answer 31

SSRI e.g. fluoxetine / prozac escitalopram / lexapro

Question 32

Fluoxetine is a

Answer 32

SSRI