Anxiolytics and Hypnotics Flashcards Preview

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Flashcards in Anxiolytics and Hypnotics Deck (26)
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1
Q

What 3 different groups of drugs can be classed as Anxiolytics?

A

Beta blockers
SSRIs
Benzodiazepines

2
Q

Why should benzodiazepines not be prescribed for extended periods?

A

High risk of dependency and abuse

3
Q

Why are Beta Blockers often prescribed to patients with anxiety?

A

To deal with the physiological effects of this disorder

4
Q

Which benzodiazepine is often prescribed in alcohol withdrawal?

A

Chlordiazepoxide (Librium)

5
Q

What is the onset time for midazolam?

A

15 to 30 minutes

6
Q

What is the mechanism of action of benzodiazepines?

A

Bind to Gamma-aminobutyric Acid (GABA) receptor -chloride channel molecule. They intensify the effect of GABA.

7
Q

What is GABA?

A

Gamma-aminobutyric Acid

A natural inhibitory neurotransmitter found throughout the brain

8
Q

What does GABA do in the body?

A

GABA is responsible for regulating the nerve impulses in the human body which helps in maintaining the muscle tone.

9
Q

What is a benefit of benzodiazepines over barbiturates

A

They do not cause life threatening respiratory depression or coma if taken in excessive amounts.

10
Q

What are common side effects of benzodiazepines?

A

Drowsiness, sedation, lethargy, ataxia.

11
Q

What is the mechanism of action of Beta-Blockers?

A

They are known as Beta-adrenoreceptor blockers

Block action of NE on Beta1,2,3 receptors (in heart, peripheral vasculature, bronchi, pancreas and liver.

12
Q

What is the common ending of Beta-blockers?

A

“olol”

13
Q

What is the advantage of water soluble beta-blockers over lipid soluble varieties?

A

Less likely to cross into brain and may therefore cause less sleep disturbances and nightmares.

14
Q

Max length of time to use Benzo’s for anxiety?

A

2-4 weeks to avoid dependency

15
Q

When should benzodiazepines not be used to treat insomnia or anxiety?

A

When insomnia is not severe

To treat short term mild anxiety

16
Q

What is the withdrawal period for Benzo’s?

A

Short term use should taper down over 2-4 weeks

Long term use should taper down over several months or more

17
Q

What are the characteristic signs of Benzodiazepine withdrawal syndrome?

A
Insomnia
Anxiety
Loss of appetite
Weight loss
Tremor
Perspiration
Tinnitus
Perceptual disturbances
18
Q

When can Benzodiazepine withdrawal syndrome occur?

A

Usually anytime up to 3 weeks after stopping long-acting benzo’s but may appear within a day of stopping short acting ones.

19
Q

What effects can occur if benzodiazepines are stopped abruptly?

A

Confusion
Toxic Psychosis
Convulsions
Condition resembling delirium tremens.

20
Q

What are the Z drugs?

A

Zaleplon
Zolpidem
Zopiclone

21
Q

Which is the most short acting Z drug?

A

Zaleplon

22
Q

What is the treatment for transient insomnia?

A

Short acting Hypnotic

1 or 2 doses prescribed only

23
Q

What is the treatment for short term insomnia?

A

Preferably only prescribe hypnotic for one week but no more than 3 weeks.

24
Q

How quickly can someone build up a tolerance to the effects of hypnotics with continuous use?

A

Within 3-14 days.

25
Q

Why might some benzodiazepines rather than hypnotics be useful to treat insomnia?

A

Where the cause of insomnia is related to daytime anxiety.

26
Q

Which drugs are not suitable for patients with unstable myasthenia gravis?

A

Z drugs