Drugs for Anxiety

Cards (59)

  • Repolarization - change in the membrane potential that returns it to negative, happens after depolarization
  • Excitatory Neurotransmitters - Opens Na or Ca channels/influx — depolarization (more positive) — nerve impulse
  • Dopamine, Acetylcholine, Glutamate, Norepinephrine, Aspartate - are excitatory neurotransmitters (Mnemo: DAGNA)
  • Inhibitory Neurotransmitters - opens Cl channels — hyperpolarization (more negative) — no nerve impulse
  • Glycine, Gamma-aminobutyric acid - are inhibitory neurotransmitters (Mnemo: GG)
  • Memorize!!
    A) Anxiety
    B) Psychosis
    C) Depression
    D) Mood Disorder
    E) Seizure
    F) Parkinson's
    G) Alzheimer's
  • Anxiety - is an emotional state commonly caused by the perception of real or potential danger that threatens the security of an individual
  • Sedative and Hypnotic - are commonly known as anti-anxiety/minor tranquilizers
  • Panic disorder - recurrent unexpected panic attacks that can occur with agoraphobia in which patients fear places in which escape might be difficult
  • Specific phobia - intense fear of particular objects or situations (e.g. snakes, heights); most common psychiatric disorder
  • Social phobia - intense fear of being scrutinized in social or public situations (e.g. giving a speech, speaking in class)
  • Generalized anxiety disorder (GAD) - intense pervasive worry over virtually every aspect of life
  • Post-traumatic stress disorder - persistent re-experience of trauma, efforts to avoid recollecting the trauma, and hyperarousal
  • Obsessive-compulsive disorder (OC) - recurrent obsessions and compulsions that cause significant distress and occupy a significant portion of one’s life
  • Benzodiazepines - most widely used anxiolytic, drug of choice for GAD
  • Chlordiazepoxide - first ever benzodiazepine
  • Clonazepam, Oxazepam, Midazolam, Triazolam (COMT) - are short acting (2-8hrs), used in order to induce sedation and hypnosis before operation
  • Flunitrazepam, Lorazepam, Alprazolam, Temazepam (FLAT) - are intermediate acting (10-20hrs), commonly used as anti-anxiety supplements
  • Diazepam, Flurazepam, Chlordiazepoxide - are long acting (1-3 days), commonly used for anti-seizure supplements
  • Alprazolam, Diazepam - drugs used for anxiety
  • Diazepam, Clonazepam, Lorazepam - drugs used for seizures
  • Flurazepam, Midazolam - drugs used for insomnia
  • Midazolam - drug used for pre-operative sedation
  • All benzodiazepines are converted to N-desmethyldiazepam as their metabolite
  • Sedative - at low doses, exert calming effects with concomitant reduction of anxiety (Clinical uses: Anxiety (GAD) and panic disorders, phobias)
  • Hypnotic - at high doses (Clinical use: for insomnia)
  • Anesthesia - at high doses: CNS depression to the point known as stage III of GA
  • Diazepam, Lorazepam - is used for IV anesthesia
  • Midazolam - is used for induction of anesthesia
  • Anticonvulsant - can exert anticonvulsant effects without marked central nervous system depression, so that mental and physiologic activity are relatively unaffected (Clinical use: some forms of epilepsy)
  • Clonazepam, Nitrazepam, Lorazepam, Diazepam - is used for some forms of epilepsy
  • Muscle Relaxant - carbamates and bzd exert inhibitory effects on polysynaptic reflexes and internuncial transmission and at high doses may also depress transmission at the skeletal neuromuscular junction (Clinical uses: muscle spasms, spastic disorders)
  • Anterograde amnesia – loss of the ability to create new memories after the event that caused the amnesia, leading to a partial or complete inability to recall the recent past, while long-term memories before the event remain intact
  • Diazepam - can be initiated as loading dose (40% of daily consumption), followed by a daily tapering of 10%
  • Clonazepam - an alternative agent to treat withdrawal symptoms for benzodiazepine
  • Phenobarbital - for mixed BZD and alcohol dependence
  • Flumazenil - doc for benzodiazepine poisoning, a benzodiazepine antagonist, GABA receptor antagonist
  • Alcohol + BZD - additive effect; lowers the therapeutic index of BZD
  • CNS depressants + BZD - synergism of adverse sedative effects
  • Lorazepam + Clozapine - respiratory suppression and death