Anxiolytics & Hypnotics

Question 1

Anxiolytic and hypnotic agents?

Answer 1

Benzodiazepines

Barbiturates

Antidepressants

Buspirone

Question 2

Examples of bzd?

Answer 2

Diazepam

Lorazepam

Clonazepam

Triazolam

Alprazolam

Question 3

Bzd antidote

Answer 3

Flumanezil

Question 4

Actions of bzd

Answer 4

Anxiolytic

Sedative, hypnotic

Anticonvulsant

Muscle relaxant

Anterograde amnesia

Question 5

Bzd used for anxiety

Answer 5

Lorazepam

Diazepam

Clonazepam

Alprazolam

Question 6

Bzd for muscle disorders

Answer 6

Diazepam

Question 7

Bzd for amnesia

Answer 7

Midazolam

Question 8

Bzd for seizures

Answer 8

Lorazepam

Diazepam

Clonazepam

Question 9

Bzd for sleep disorders?

Answer 9

Long acting: flueazepam

Intermediate: temazepam

Short acting: triazolam

Question 10

Withdrawal symptoms of bzd?

Answer 10

Confusion

Anxiety

Agitation

Insomnia

Question 11

Adverse effects of bzd

Answer 11

Drowsiness

Confusion

Cognitive impairment

Question 12

Precautions of bzd

Answer 12

Liver disease

Avoided in patients with narrow angle glaucoma

Synergistic effect with alcohol

Question 13

Antidepressants used?

Answer 13

Ssri: escitaloprim

Snri: venlafaxine

Question 14

Buspirone is used for?

Answer 14

Chronic treatment of generalized anxiety disorder

Question 15

Moa of buspirone?

Answer 15

Works on serotonin receptors

Question 16

Advantages of buspirone

Answer 16

Minimal adverse effects
(Headache, dizziness)

Low sedation and low cognitive dysfunction

Low abuse potential

Question 17

Disadvantages of buspirone

Answer 17

Slow onset of action

Hypothermia

Increases prolactin and GH levels

Question 18

Do barbiturates have an antidote

Answer 18

No

Question 19

Why were barbiturates largely replaced by bzd

Answer 19

Severe withdrawal symptoms

Physical dependence

Tolerance

Drug metabolizing enzymes

Question 20

Actions of barbiturates is divided based on?

Answer 20

Durations of action

Question 21

Ultra rapid barb?

Answer 21

Thiopental

Induction of anesthesia

Question 22

Short acting barb?

Answer 22

Pentobarbital

Secobarbital

Amobarbital

Sedative hypnotic (not anxiolytic)

Question 23

Long acting barb?

Answer 23

Phenobarbital

TTT of seizures

Question 24

Actions of barbiturates?

Answer 24

Cns depression:

Low doses sedative
High doses hypnosis anesthesia coma death

Respiratory depression followed by death

Enzyme induction of cyp450

Question 25

Therapeutic uses of barb

Answer 25

Anesthesia Anticonvulsant Sedative hypnotic

Question 26

Adverse effects of barbiturates

Answer 26

Cns: drowsiness, impaired conc, synergize with ethanol Drug hangover Physical dependence: withdrawal symptoms (cardiac arrest, restlessness, seizures) Poisining (leading cause of death) Soln: alkalinization of urine to elim phenobarbital

Question 27

Other hypnotic agents

Answer 27

Zolpidem Zaleplon Ramelteon Antihistamines Ethanol

Question 28

Moa of zolpidem

Answer 28

Acts of bzd receptor

Question 29

Adverse effects of zolpidem

Answer 29

Nightmares Agitation Headache Git upset

Question 30

Moa of ramelteon

Answer 30

Selective agonist on mt1 and mt2 (melatonin) to induce and promote sleep

Question 31

Safest hypnotic?

Answer 31

Ramelteon

Question 32

Antihistamines?

Answer 32

Diphenhydramine Hydroxyzine Doxylamine

Question 33

Effects of ethanol

Answer 33

Anxiolytic Sedative

Question 34

Treatment of ethanol addiction

Answer 34

1. Behavioral therapy 2. Disulfiram (inhibits aldehyde dehydrogenase) aldehyde accumulates leads to n&v, tachycardia, flushing 3. Acamprosate and naltrexone (decrease ethanol craving)

Question 35

Antidote for methanol

Answer 35

Ethanol injection

Question 36

Antidote for all alcohols

Answer 36

Fomipizole

Question 37

First line treatment of anxiety

Answer 37

Ssri: escitalopram, fluoxetine, paroxetine, sertraline Snri: duloxetine, venlafaxine

Question 38

Second line treatment of anxiety

Answer 38

Buspirone Tca: amitryptiline Hydroxizine Pregabalin Gabapentin

Question 39

Performance anxiety?

Answer 39

Propanol

Question 40

Non drug treatment of insomnia

Answer 40

Quiet dark and comfortable bedroom Avoid daytime naps Reserve bedroom for sleep Turn face of clock aside Prebedtime ritual Avoid exercise before bedtime

Question 41

Drugs for induction of sleep

Answer 41

Eszopiclone Zolpidem Zaleplon Ramelteon

Question 42

Drugs for maintenance of sleep

Answer 42

Eszopiclone Zolpidem Doxepin (antidepressant) Suvorexant (orexon receptor antagonist)

Question 43

Drugs for maintenance and induction

Answer 43

Zolpidem Eszopiclone

Question 44

Bzd for sleep

Answer 44

Lorazepam Temazepam

Question 45

Restless leg syndrome

Answer 45

Ropinirole, pramipexole, rotigotine Gabapentin

Question 46

How is narcolepsy treated?

Answer 46

With stimulants Modafenil Armodafinil

Question 47

Adverse effects of modafinil and armodafinil

Answer 47

Rash

Question 48

Narcolepsy with catalepsy ttt?

Answer 48

Sodium oxybate