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Pharm Final UNIT!!!! > Anxiolytics > Flashcards

Flashcards in Anxiolytics Deck (20):
1

How is acute anxiety treated?

Benzodiazepines prn

2

How is chronic anxiety treated?

SSRI or SNRI, may take weeks for max effect so treat interim with BZD prn short term

3

What general information is important to know about Benzos?

-Controlled substance IV
-If chronic use taper slowly, abrupt D/C can be fatal

4

How do benzos work?

Bind to GABA receptors and enhance inhibitory effect on neurons

5

What actions are associated with benzodiazepines?

-Reduction of anxiety
-Impaired memory (anterograde amnesia)
-sedative and hypnotic actions
-Anticonvulsant
-Muscle relaxant

6

What patient population do Benzos have a huge caution/ do not use in?

Elderly (can accumulate due to long 1/2 life and low metabolism)

7

What benzos have a long 1/2 life? How long is their 1/2 life?

-Klonopin
-Valium
-Librium (ETOH abuse)
-25-100 hour 1/2 life

8

What are the medium interval benzos and their 1/2 life?

-Lorazepam (Ativan)
-Temazepam (Restoril)
- 10-15 hours

9

What are the short half life Benzos? What is 1/2 life?

-Alprazolam (Xanax)
-Oxazepam (Serax)
<12 hour 1/2 life

10

What ADRs are associated with all types of BZDs?

-Drowsiness
-Confusion/ cognitive impairment (driving)
-Ataxia

11

Other than the elderly what other areas require caution with use of BZDs?

-Other CNS drugs ETOH/Opioids
-Glaucoma
-Hepatic dz
-Renal dz

12

What occurs in long term/ abrupt withdrawal from benzos?

-Seizures
-Agitation
-Restlessness
-Anxiety
-Confusion

13

What type of Benzos have the most severe w/drawal sx (and faster onset)?

Short term BZDs (Xanax, Serax)

14

What is important to remember about PK of Benzos?

-They are metabolized by the liver to active metabolites, must consider for clinical duration as well
-Major CYP inhibitors affect PK (3A4, 2c19)

15

Are BZDs good drugs to use in pregnant pts?

No they carry D or X rating and can be passed through breast milk to nursing baby

16

What drug should be used in a suspected BZD overdose?

Flumazenil (reversal conscious sedation/ BZD receptor antagonist)

17

What drug is used in chronic anxiety tx only?

Buspirone

18

What is beneficial about Buspirone?

Lacks anticonvulsant and muscle relaxant properties with minimal sedation

19

What ADRs associated with Buspirone?

Hypothermia, Increase prolactin and growth hormone

20

Why is Buspirone not preferred over SSRI/ SNRI for treatment of chronic anxiety?

Does not work as well