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36 Cards in this Set
- Front
- Back
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Indications of BDZ (6)
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1) Anxiolytics
2) Preanesthesia 3) Status epilepticus 4) Muscle relaxant 5) Insomnia tx 6) Alcohol withdrawal |
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Buspirone indication (1)
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Generalized Anxiety Disorder
Nothing else at the moment |
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BDZ mechanism of action
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Increase frequency of opening of CNS GABA receptors
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How do GABA-A receptors work?
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Chloride ion channels
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How do GABA-B receptors work?
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Work by second messenger system
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GABA, what is it?
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Inhibitory NT
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Benzos affect GABA channels where in the brain?
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Limbic system
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What neurotransmitter is implicated in anxiety disorders?
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GABA
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What are some findings that support GABA as problematic NT in anxiety disorders (3)
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1) Reduced # of GABA receptor in CNS of anxiety patients
2) Reduced responsiveness of remaining GABA receptors in anxiety patients 3) Reduced concentration of cortex in the cortex |
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Psychiatric uses of BDZ (6)
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1) Anxiety disorders in general
2) Psychiatric DO with anxiety component 3) Insomnia (short term) 4) Alcohol WD 5) Akathisia from neuroleptics 6) Catatonia (Lorazepam) |
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Which BDZ is especially good for catatonia?
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Lorazepam
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High potency BDZ (5)
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Lorazepam
Alprazolam Triazolam Clonazepam Diazepam |
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Low potency BDZ (4)
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Temazepam
Oxazepam Flurazepam Chlordiazepoxide |
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Which BDZ is used in alcohol detox
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Chlordiazepoxide (Librium)
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Fasting onset BDZ have what problem...
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Feeling of a high and are more addictive
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Which BDZ are used for panic disorder
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Alprazolam, Clonazepam
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Which BDZ are used for insomnia?
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Flurazepam, Triazolam, Diazepam
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What general type of BDZ quality is looked for in controlling panic DO
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High potency
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What general type of BDZ quality is looked for in controlling insomnia
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Fast onset
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Which BDZ are metabolized by conjugation? (3)
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"LOT"
Lorazepam Oxazepam Temazepam |
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Which BDZ are metabolized by oxidation?
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All the others besides "LOT"
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What do you need to worry about in BDZ that are metabolized by oxidation?
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People with liver problems may not be able to metabolize them as well
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What is a perk of having a long BDZ half life?
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Less likely to get interdose symptom rebound for things such as panic DO
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What is a perk of having a short BDZ half life?
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Can be used for insomnia and reduce residual daytime sedation
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Which BDZ have active half lives?
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"LOT" + Clonazepam = "CLOT"
Clonazepam (makes a clone of itself) Lorazepam Oxazepam Temazepam |
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Problem with removing BDZ too quickly?
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Rebound with seizures
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Problem with using BDZ too long?
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Dependence and tolerance
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BDZ + Elderly?
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Increase the risk of falls resulting in large bone fractures
Also increased MVA |
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Benzo S/E
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Respiratory depression
Disinhibition (in elderly) Fatal CO2 retention in COPD pts Cognitive impairment (long term use) Death (when combined with barbs or alcohol) |
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Buspirone favored over BDZ in what patients?
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Those with GAD and a history of drug abuse
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Mechanism of Buspirone action?
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Agonist at 5HT-1A receptor
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Why can't buspirone be used to treat BDZ / Alcohol withdrawal?
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It has no GABA receptor affinity and thus is NOT useful in treating BDZ / Alcohol withdrawal
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Why can't buspirone be used to treat insomnia?
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It has no sedative properties
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Buspirone S/E?
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Dizzy, sleepy, nervous, nausea
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Buspirone dependence/withdrawal?
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None!
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Time difference between BDZ + Buspirone?
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BDZ have effect immediately
Buspirone may take weeks May use BDZ for anxiety during the time it takes Buspirone to take effect |
