Anxiolytics Flashcards Preview

Psychiatry > Anxiolytics > Flashcards

Flashcards in Anxiolytics Deck (20):
1

How do benzodiazepines work?

Bind to GABA receptors and enhance the action of GABA (inhibition)

2

Effects of benzodiazepines
Always
Another
Stupid
Mnemonic
About
Amnesia

(reduce) Anxiety
(reduce) Aggression
Sedation
Muscle relaxant
Anti-convulsant
Anterograde amnesia

3

What is anterograde amnesia

Inability to form new memories after the (event causing) amnesia

4

Main inhibitory transmitter in the brain

GABA

5

How does GABA work?

Causes hyperpolarisaion of target cells (allows Cl- to enter)

6

Antagonist to benzodiazepines (i.e. could give if you overdose)

Flumazenil

7

Name 2 SSRI's you could prescribe for generalised anxiety disorder

-escitalopram
-paroxetine

8

If someone overdoses on benzos what could you give them?

Flumazenil

9

How to withdraw benzodiazepines

1) Transfer patient to equivalent daily dose of diazepam/chlordiazepoxide preferably taken at night

2) Reduce dose every 2–3 weeks in steps of 2 or 2.5 mg; if withdrawal symptoms occur, maintain this dose until symptoms improve

3) Reduce dose further, if necessary in smaller steps; it is better to reduce too slowly rather than too quickly

4) Stop completely; time needed for withdrawal can vary from about 4 weeks to a year or more

10

Benzodiazepines and monoamines

Benzodiazepines block increases of NA and 5-HT release

11

Name a 5-HT1A agonist

Busipirone

12

What can happen if you withdraw benzodiazepines rapidly?

Rapid withdrawal may cause confusion, toxic psychosis and even convulsions

13

SSRI's for GAD?

Escitalopram, paroxetine

(you could also use venlaxafine and this may help prevent subsequent development of depression)

14

Drugs for OCD

SSRI's
TCA's

15

Driving and benzodiazepines

Patients should be advised not to drive when on benzos

16

Drug for social anxiety disorder

Moclobemide

17

The locus coeruleus projects onto the prefrontal cortex and the hippocampus, what does it release if there are stressfsul/anxiogenic stimuli

Releases NA
(benzos block this increase)

18

What does the dorsal raphe nucleus release if there are stressful/anxiogenic stimuli?

5-HT
(benzos block this increase)

19

How does pregabalin work?

Ca2+ channel blocker, GABA enhancer
-only considered if not responsive to other treatments

20

How long should you prescribe benzodiazepines for?

Max 2-4 weeks