Anxiolytics Flashcards Preview

Term IV: Behavioral Science > Anxiolytics > Flashcards

Flashcards in Anxiolytics Deck (27):
1

Gold standard for treatment of anxiety disorders

SSRI or SNRI or TCA

2

What drugs are SSRI's contraindicated with

MAOIs

3

How should you dose SSRI

Start low, gradually increase

4

Are SSRIs safe to take with pregnancy

Not really - category C - they could be harmful, but we're not sure

5

What is the only SSRI does not lead to discontinuation syndrome?

Fluoxetine (Prozac)

6

SNRI's can be used for anxiety disorder

Venlaxafine (Effexor)
Duloxetine (Cymbalta)

7

MAOI's can be used for anxiety disorder

Tranylcypromine (Parnate)
Phenelzine (Nardil)

8

Imipramine (Tofranil)
Clomipramine (Anafranil)

TCA's can be used for specific anxiety disorders:

Imipramine (Tofranil) - panic disorders
Clomipramine (Anafranil) - OCD

9

What antidepressant should be avoided to treat anxiety disorder?

Buproprion (Wellbutrin)

10

How long does it take for these medications to start working?

2-4 weeks - has to be gradually increased, has to be taken daily

11

Barbiturates (-barbital)

Mechanism?

Bind within GABA-mediated chloride ion channel and increase chloride ion conductance into cell by increasing DURATION of opening, hyperpolarizes neuron, reduces excitability of neurons, depresses CNS

Increases chloride ion conductance INDEPENDENTLY of GABA

12

Are barbiturates dangerous in overdose? High potential for dependence?

YES and YES- fatal

13

Benzodiazepines

Mechanism?

Bind to BZD receptors associated with GABA receptor, enhancing GABA's ability to increase chloride ion conductance

GABA increases FREQUENCY of opening, hyperpolarizes neuron, reduces excitability of neurons, depresses CNS

14

Which is less dangerous - benzodiazepines or barbiturates and why?

Benzodiazepines - they compete with GABA, so GABA availability is the rate-limiting step

15

When are benzodiazepines dangerous?

When mixed with other CNS depressants like alcohol - avoid giving to alcoholic patients

16

What drug can you give to reverse effect of benzodiazepines in overdose?

Flumazenil (benzodiazepine receptor antagonist)

17

Side FX of benzodiazepines?

Ataxia and falls in elderly
Confusion, memory impairment
Paradoxical excitation
REM suppression
Dependence and abuse potential

18

BZD1 (CNS) receptor

sleep

19

BZD2 (CNS) receptor

confusion, cognition, motor control

20

BZD3 (peripheral) receptor

muscle relaxation

21

Alprazolam (Xanax)

Benzodiazepine

Fast onset of action, but short duration of effect

As a result, not good for treating anxiety

22

Diazepam (Valium)

Benzodiazepine

Fast onset of action, longer duration of effect

23

Clonazepam (Klonopin)

Benzodiazepine

Slow onset of action, long duration of effect

24

Lorazepam (Ativan)
Oxazepam (Serax)
Temazepam (Restoril)

Benzodiazepines that do not require oxidation for elimination (no liver required):

Good for patients w/ liver impairment

25

Zolpidem (Ambien)
Zaleplon (Sonata)
Eszopiclone (Lunesta)

- Zolpidem (Ambien) - mid-range acting
- Zaleplon (Sonata) - shortest acting
- Eszopiclone (Lunesta) - longest acting

Selective BZD receptor agonists

26

Buspirone (Buspar)

Non-BZD, non-barbiturate anxiolytic

Partial agonist at 5-HT1A receptor

No abuse potential

Side FX: dizziness, headache, nausea

27

Propranolol (Inderal)
Metoprolol (Toprol)

Beta-blockers used for stage fright