Anxiolytics, Hypnotics & Sedatives

Question 1

What are the major mediators of the symptoms of anxiety disorders?

Answer 1

gamma-aminobutyric acid (GABA), norepinephrine, serotonin, and dopamine.

Question 2

Why are BDZ’s used for anxiety disorders?

Answer 2

Benzodiazepines (BDZs) have been used extensively for anxiety disorders
due to their anxiolytic, hypnotic, muscle relaxant, anticonvulsant and amnesic
action.

Question 3

Why are anxiolytics used for sleeping disorders?

Answer 3

Anxiolytics may be clinically used for sleep disorders (e.g. insomnia) due to
their sedative and hypnotic (sleep-inducing) effects.

Question 4

Anxiety meaning?

Answer 4

Disorders are characterised by a feeling of apprehension,
uncertainty and fear without any apparent stimulus.

Question 5

Anxiety disorders?

Answer 5

Disorders:
*Generalised Anxiety Disorder (GAD)
*Phobias
*Panic Disorder (PD)
*PTSD
*OCD

Question 6

Anxiety disorders symptoms?

Answer 6

STOMACH

Sweating/Sleeping disorder
Tremor/Tachycardia
Organic Causes to be ruled out
Motor Tension
Arrthymias
C
Hyperventilation

Question 7

Anxiety goals for treatment?

Answer 7

-Fear extinction
-Blocking reconsolidating of fear memories

Question 8

Drugs treatment for anxiety?

Answer 8

• Benzodiazepines
• Barbiturates
  *SSRIs

Question 9

What are GABA-gated channels targets for?

Answer 9

*Benzodiazepines
*Barbiturates
*Alcohol
*Cannabis

These drugs act at different sites to increase opening of the channel
and thus enhance inhibitory synaptic transmission (note: presence
of any of the 4 influences the binding of the others)

Question 10

Why are benzodiazepines most commonly used?

Answer 10

due to their superiority regarding safety and effectiveness compared to barbiturates

Question 11

Benzodiazepines MOA?

Answer 11

Bind to a specific regulatory receptor site on the GABAA receptor →
enhance inhibitory effect of GABA →
Allosteric enhancement of Cl conduction→ increase frequency of
channel opening; hyperpolarisation

Results:
anxiolysis, sedation and
hypnosis, muscle relaxation, suppression of convulsions.

Question 12

Benzodiazepines pharmacological Effects?

Answer 12

STOMACH

Sedation
Tremor
O
M
Anxiolytic/Anaesthetic/Awareness(Hyponsis
Coma/Death
Hypnosis

Question 13

Classifications of Benzodiazepines?

Answer 13

1. Sedative hypnotics
2. Anxiolytixs

Question 14

What are the short acting/sedative drugs?

Answer 14

Usually short acting and ultra-short acting

AT(2)OM

‘A’ stands for alprazolam
T’ stands for triazolam and Temezapam
‘O’ stands for oxazepam
‘M’ stands for midazolam.

Question 15

What are the anxiolytics drugs?

Answer 15

Usually long and intermediate acting

Long drugs feel calming

Lorazepam
Diazepam
Flunitrazepam
Chlordiazepoxide

Question 16

Which BDZ’s are safe to use for patients in liver disease?

Answer 16

Outside the liver

Oxazepam
Temazapam
Lorazepam

Question 17

What are the antidote for BDZ overdose?

Answer 17

Ben Is off with FLU

Flumazenil
Lithium

Question 18

What are the contraindications of Flumazenil?

Answer 18

Dependence
Mixed doese with CVS
CNS toxic(TCA)

Question 19

Benzodiazepines drugs for insomnia?

Answer 19

Dreams Terrify

Familys
Temazepam
Flurazepam

Question 20

Which BDZ drugs is used for anxiety an delirium?

Answer 20

Drugs are Calming

Chlordiazepoxide
Diazepam

Question 21

Benzodiazepines drugs for sedation?

Answer 21

Keep some on the DL-sedated

Diazepam
Lorazepam

Question 22

Benzodiazepines side effects?

Answer 22

Sedation
Depression
Hyper excitability in children

Question 23

What is the main neurotransmitter that innervates the amygdala?

Answer 23

Serotonin

Question 24

Which accessory organ plays a function in the experience of fear and anxiety?

Answer 24

amygdala

Question 25

What are the Selective Serotonin Re-uptake Inhibitors(SSRIs)?

Answer 25

FESC (FUSEK FEELINGS) Fluxoxetine Escitalopram Sertraline Paroxetine

Question 26

SSRI's MOA?

Answer 26

prevent the presynaptic reuptake of 5-HT → more 5-HT to stimulate postsynaptic 5-HT receptors (5-HT1; antidepressant and anxiolytic effects)

Question 27

SSRI's S/E?

Answer 27

BAD SSRI Body weight increase Anorexia Dizziness Suicidal Thoughts Serotonin Syndrome Reproductive-Sexual Dysfunction Insomnia

Question 28

SSRI's drug interactions?

Answer 28

do not use with MAOIs; fluoxetinecan inhibit cytochrome P-450 isoenzymes and thus the metabolism of certain β-blockers including propranolol and metoprolol → hypotension, bradycardia

Question 29

SSRI drugs and functions?

Answer 29

Effective for Sadness, panic and compulsions? Escitalopram Fluxoxetine Sertraline Paroxetine

Question 30

Serotonin Syndrome components side effects?

Answer 30

HARM Hyperthermia Autonomic Instability(Delirium) Rigidity Myoclonus

Question 31

Which drugs cause Serotonin Overdose ?

Answer 31

MAO-1 Lithium Methampetamine TCA's

Question 32

Other hypnotic agents MAO?

Answer 32

-None Benzodiazepine but selectively bind to BDZ-1 receptors .

Question 33

Other hypnotic drugs?

Answer 33

Z3-The Z drugs Zopiclone Zolpidem Zalepron

Question 34

Other hypnotic drugs half-life duration?

Answer 34

Shorter half-life than BDZ-1

Question 35

What are the benefits of this short life of BDZ?

Answer 35

Have reduced propensity to cause tolerance and have less abuse liability

Question 36

Which other hypnotic dug has the shortest half-life and what is the benefit of that?

Answer 36

Zalepron Zalepronhas such a short half-life that it can be used to treat midle-of-the-night insomnia as long as 5hrs elapses before driving or operating machinery

Question 37

What other hypnotic drugs are used for antihistamines?

Answer 37

Antihistamines: Diphenhydramine, Hydroxyzine

Question 38

What other hypnotic drugs are used for antidepressants ?

Answer 38

Doxapen