Lecture 37 - Anxiolytics and Hypnotics Flashcards Preview

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Flashcards in Lecture 37 - Anxiolytics and Hypnotics Deck (12):
1

3 anxiolyitcs; order and clinical uses

First line -- SSRIs
Second line - Buspar
Acute setting - benzos

2

SSRIs
the bad

takes a few weeks to get benefits
HA, Fatigue, sexual dysfucntion

3

Buspar
mechanism
the bad
the good

5ht1a agonist
Good: few side effects; no reactions wtih ETOH
no sedation, or addiction potential
The bad: takes time for benefits;

4

Benzos --
clinical use
mechanism (receptor, subtype, subunit)

the bad

acute anxiety

Increases open potential of GABA-a receptor (chloride channel)
alpha 2 subunit -anxiety mediation

the bad -- abuse potential; bad to mix with ETOH;
Dizaepam -- active metabolites
addiction
withdrawal

5

what is narcolepsy --

Mutation in Hypocretin Receptor 2
Humans -- loss of lateral hypothalamic neurons (autoimmune) to produce hypocretin

6

what are the Z drugs?

some side effects?

AmbienCR (zolpidem CR) Lunesta (eszopiclone) Sonata (zaleplon)

night walking, night eating; but minor compared to

7

what drugs are used to treat insomina

Benzos
Z drugs --AmbienCR (zolpidem CR) Lunesta (eszopiclone) Sonata (zaleplon)

Trazadone
Benadryl
Melatonin

8

mechanism for sedation of these drugs (receptor, subtype, subunit)

GABA-a
alpha 1 subunit

9

Some benefits of in regards to hypnosis of Z drugs over benzos

Benzos -- slower rise to hypnotic effect; reboind insomina when taken off the drug
SE: ataxia;


Z --
rapid rise hypnotic effect; no rebound insomina

fewer side effects

10

metabolism of benzos?

oxidation/Glucuronidation in the Liver

slows with age

11

subunity for anxiolytics


subunit for sedation

alpha 2 of gaba-a

alpha 1 of gaba-a

12

what drug do you give for a BZD OD?

Flumenzanil