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Flashcards in Anxiolytics Deck (18)
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1
Q

What do benzo’s do?

A

They bind to GABA receptors, thereby increasing activity and increasing inhibition

2
Q

What is the most prevalent inhibitory neurotransmitter in CNS?

A

GABA (gamma-aminobutyric acid)

3
Q

What other substances also bind to GABA receptors?

A

Alcohol & barbiturates, although they have their own binding sites and slightly different ways of affecting the receptors

4
Q

Why shouldn’t alcohol, barbiturates, and BZD’s be combined?

A

Because together they have an additive/synergistic effects that can be fatal.

5
Q

What are the therapeutic effects of BZD’s?

A

Decrease anxiety temporarily
Induce anterograde amnesia for medical procedures
Induce sedation for agitation, sleep for insomnia
Relax muscles for spasms
Raise seizure threshold (e.g. alcohol withdrawal)

6
Q

What are the SE’s of BZDs?

A
  • Paradoxical agitation (anxiety, aggression, behavioral disinhibition)
  • Sedation, drowsiness, lethargy, depression (especially in elderly)
  • Confusion, cognitive impairments, impaired learning, amnesia (even dementia)
    Ataxia, resulting in falls in elderly
    -Slurred speech
    -Dependence
    -Interactions with alcohol/other sedatives
    Possible fetal abnormalities
7
Q

Paradoxical agitation

A

One of the SE of BZD’s in which the pt experiences increases in anxiety, agression and behavioral disinhibition

8
Q

T or F: With few exceptions, BZD’s should only be used for a few weeks for temporary relief until other therapy techniques can take effect.

A

T

9
Q

T or F: BZD’s may interfere with CBT

A

T

10
Q

T or F: BZD’s are never prescribed for long periods

A

F; BZD’s are very commonly and inappropriately prescribed for long periods.

11
Q

What are the 1st-line Rx for anxiety disorders due to efficacy and to the SE’s of sedative-hypnotics?

A

SSRI’s

12
Q

What is considered responsible for effectiveness of SSRI’s for anxiety?

A

5-HT usually decreases anxiety and frequently inhibits behaviors; however, 5HT2 receptors may cause anxiety until they downregulate/desensatize

13
Q

What are the two biggest problems with prescribing mirtazapine (Remeron) (which is NOT a BZD)?

A

Weight gain

Hypersomnia

14
Q

Which antidepressants are commonly prescribed for anxiety?

A

See slides

15
Q

What is the first line treatment for OCD?

A

SSRI’s

16
Q

What is the second line treatment for OCD?

A

Best option are high doses of SSRI’s or augmentation with an atypical antipsychotic
Also used are clomipramine (Anafranil), MAOI, and SNRI.

17
Q

What is the 1st line treatment for PTSD?

A
  • SSRI’s
  • SNRI’s
  • For patients who are left with residual sxs, an alpha1 antagonist at night may prevent nightmares.
18
Q

What is the second line treatment for PTSD?

A

alpha2sigma ligands, TCA’s, MAOI’s, BZD’s (w/ caution because many abuse substances)