Anti-anxiety Agents (Exam 5)

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44 Terms

1

severe respiratory depression; teratogenic; depress liver and kidney function; reduce GI motility; lower body temperature

What are the 5 adverse effects of barbiturates?

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2

zolpidem (ambien); zaleplon; eszopiclone

What are the 3 Z compounds?

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3

aloprazolam (xanax); clonazepam (klonopin); lorazepam (ativan)

What are the 3 most prescribed anti-anxiety drugs in the U.S. (all 3 are benzodiazepines)?

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4

-zolam; -zepam

What are the 2 suffixes for benzodiazepines?

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5

klonopin

What is the trade name for clonazepam?

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6

sedation

- decrease activity
- moderates excitement
- calms the recipient
- increase respiratory depression (caution)

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7

hypnosis

- drowsiness
- facilitates the onset and maintenance of sleep that resembles natural sleep

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8

cause membrane hyper-polarization (makes it more negative which leads to neuronal inhibition because it makes it hard to cause action potential)

How does benzodiazepines change the membrane potential of neurons?

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9

cns depression; anterograde amnesia; respiratory effects (apnea); visual and dental effects (contraindicated in narrow angle glaucoma; xerostomia, swollen tongue and bitter/metallic tase); thrombophlebitis (blood clot)

What are the 5 adverse effects of benzodiazepines

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10

myathenia gravis; obstructive sleep apnea; acute angle closure glaucoma

What are the 3 contraindications of benzodiazepines?

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11

flumazenil

What is benzodiazepine antagonist?

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12

acute barbiturate poisoning (overdose)

How did Marilyn Monroe die?

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13

thiopental

What is the ultra short acting barbiturate?

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14

zolpidem (ambien)

Z compound:
- quick onset of action
- sife effects: headache, drowsiness, dizziness and diarrhea
- ambien: a controlled release dose form

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15

anxiolytic; sedative; hypnosis; sleep; amnesia

What are the 5 effects of sedative-hypnotic agents?

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16

benzodiazepines

What is the most popular class of medication is used for anti-anxiety?

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17

xanax

What is the trade name for alprazolam?

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18

ativan

What is the trade name for lorazepam?

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19

yes

Can a drug produce both sedation and hypnotic effects?

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20

GABA

What receptors do benzodiazepines activate?

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21

NMDA; AMPA

What 2 receptors cause excitatory neurosignaling?

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22

GABA

What receptor causes inhibitory neurosignaling?

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23

balance; inhibitory

NMDA/AMPA (excitatory receptors) and GABA (inhibitory receptors) are in _______________ but when drugs activate GABA ______________ signaling occurs

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24

decreased excitatory neurosginaling

What would happen if you blocked NMDA receptors?

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25

enhance

Do benzodiazepines enhance or inhibit the GABA activity?

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26

chloride

What ion is involved with GABA receptors?

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27

less likely

Is the neuron more or less likely to fire action potential after a patient take a benzodiazepine?

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28

wider therapeutic range; less addictive

In what 2 ways are benzodiazepines "better" (or safer) than barbiturates?

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29

yes

Can you be addicted to benzodiazepines?

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30

seizures (so must taper off)

What can happen if patient abruptly stops taking benzodiazepines?

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31

yes

Can you develop tolerance to benzodiazepines?

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32

Benzodiazepine overdose (do not use when a patient has been taking benzos for a long time; Xanax + flumazenil = withdrawal symptoms and seizures)

When is flumazenil used?

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33

decrease (by increasing metabolism which decreases bioavailability since rifampin induces CYP3A4)

Does rifampin (for TB) increase or decrease the therapeutic effect of benzodiazepines?

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34

increase (by decreasing metabolism which increases bioavailability since GF juice inhibits CYP3A4)

Does grapefruit juice increase or decrease the therapeutic effects benzodiazepines?

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35

high rates of abuse; complete cardiovascular and respiratory depression with overdose; narrow therapeutic range

What 3 things makes barbiturates more unsafe compared to benzodiazepines?

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36

respiratory depression

decrease in depth and rate of breathing

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37

Barbiturates

MOA of _________________:
- prolongs the period of Cl- ion channel opening

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38

Benzodiazepines

MOA of _________________:
- increases frequency of Cl- ion channel opening

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39

alprazolam; clonazepam

Which 2 benzodiazepines are subject to CYP3A4-mediated metabolism?

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40

lorazempam

What benzodiazepine is not subject to CYP3A4-mediated metabolism?

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41

false

True or False?
You can combine benzos and barbiturates (sedatives) with other CNS depressants

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42

benzodiazepine receptors

What receptor do z compounds act on?

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43

insomnia

What are z compounds mainly prescribed for?

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44

can cause breathing problems

Why is it not a good idea to mix benzos or z compounds with alcohol?

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