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19 Cards in this Set

  • Front
  • Back
Antianxiety agents
Benzodiazepines

What do they end in?
There are 7, name as many as you can.

What is their MOA? (same for all)

What are AE? (same for all)
Antianxiety agents
Benzodiazepines

All end in -am, some -pam, some -lam

-pam
Lorazepam (Ativan)
Diazepam (Valium)
Clonazepam (Klonopin)
Temazepam (Restoril)
Flurazepam

-lam
Alprazolam (Xanax, Niravam)
Triazolam (Halcion)
Estazolam

MOA: Potentiates actions of endogenous GABA at the GABA receptor/chloride ion channel complex

AE:CNS depression, drowsiness, incoordination, weak respiratory depression, low abuse potential
Which benzodiazipines are used for insomnia?

Hint:
There are 4, 2 -pam, 2 -lam
BZDs for insomnia:

Temazepam (Restoril)
Flurazepam

Triazolam (Halcion)
Estazolam
Which benzodiazipines are used for Generalized Anxiety Disorder & panic attacks? (3)
BZDs for GAD and panic:

Alprazolam (Xanax, Niravam)
Diazepam (Valium)
Lorazepam (Ativan)
What BZDs have fast onset? (4)

Which of them are long acting? (4)

Which of them have intermediate length duration? (3)

Which is short acting? (1)
Fast acting:
Diazepam (Valium)
Temazepam (Restoril)
Alprazolam (Xanax, Niravam)
Triazolam (Halcion)
Flurazepam

Long acting?
Diazepam (Valium)
Clonazepam (Klonopin)
Flurazepam
Estazolam

Intermediate length of duration?
Alprazolam (Xanax, Niravam)
Lorazepam Ativan
Temazepam (Restoril)

Short acting?
Triazolam (Halcion)
Which BZDs have active metabolites?
Alprazolam (Xanax, Niravam)
Clonazepam (Klonopin)
Diazepam (Valium)-2 active mets
Flumazenil (Romazicon)

Class?
Indication?
MOA?
AE?
Class: BZD antagonist

Indication: reversal of BZD effects

MOA: BZD derivative that antagonize CNS depressant effects at same receptor

AE: seizure, dizziness, N/V, HTN, flushing, arrythmias
"BZD-like" drugs/anti-anxiety
Zolpidem (Ambien)
Zaleplon (Sonata)
Eszopiclone (Lunesta)

Indication?
MOA?
AE?
Which 1 is longer acting?
Zolpidem (Ambien)
Zaleplon (Sonata)
Eszopiclone (Lunesta)

Indication: Insomnia, induction of sleep

MOA: Bind to BZD receptor site of the GABA/chloride ion channel complex (only found in CNS)

AE: daytime drowsines, dizziness, N/D/V, anaphylactic reactions

Eszopiclone (Lunesta) is longer acting. Ambien & Sonata have shorter 1/2 lives
Buspirone (Buspar) is a non-BZD antianxiety agent

Indication?
MOA?
AE?
Indication: relief of anxiety, slower onset of anxiolytic activity, does not produce dependence, no abuse potential, no additive effects w/ other CNS depressants

AE: dizziness, drowsiness, fatigue, headache, insomnia, tinnitus, tachycardia, chest pain, rashes

MOA: Partial 5HT-1 agonist, binds to serotonin and DA receptors in CNS
Barbituates (4)
MOA? (same for all)
AE? (same for all)

Hint: 3 end in -tal, 4th in -al and is 2 words
Phenobarbital (Luminal)
Secobarbital (Seconal)
Thiopental (Pentothal)
Chloral hydrate (Aquachloral, Suprettes, Somnote)

MOA: CNS depressants, act at GABA/chloride ion channel complex to bind to BZD receptor site "


AE:respiratory depression, suicide, hyperalgesia, drug interactions result frm induction of CYP 450 enzyme, additive effects w/ other CNS depressants
Phenobarbital (Luminal)

Class?
Indication?
Onset & duration?
Schedule? (Class II, III, IV, etc)
Class: Barbituates

Indication:Seizures

fast onset(0.5min)
short duration (20min)

Schedule: Class IV
Secobarbital (Seconal)

Class?
Indication?
Onset/duration?
Schedule?
Class: Barbiturate

Indication: insomnia

10-15 min onset
3-4 hrs duration

Schedule: II (high potential for misuse)
Thiopental (Pentothal)

Class?
Indication?
Onset/duration?
Schedule?
Class: Barbiturate

Indication: induction of anesthesia, seizures

60 min or less onset
10-12 hrs duration

Schedule: Class III
Chloral hydrate (Aquachloral, Suprettes, Somnote)

Class?
Indication?
Onset/duration?
Schedule?
Class: Barbiturate

Indication: Short term sedation; sedation, induction of sleep

Fast onset, short acting

Schedule: Class IV
Amitriptyline (Elavil)
Desipramine (Norpramin)
Nortriptyline (Pamelor)

Note: all end in -ine

Common therapeutic use?
Class?
MOA?
Biggest concern?
CI?
AEs?
Which 2 are secondary amines?
Amitriptyline (Elavil)
Desipramine (Norpramin)
Nortriptyline (Pamelor)

Indication: antidepressants, used to treat neuropathic pain

Class: Tricyclic antidepressants
(TCAs) "-ine suffix"

MOA: prevent removal and potentiates effect of serotonin and NE in CNS, significant anticholinergic effect

**Black box warning for increased suicide risk**

CI: Do not use with alcohol
AE: constipation, seizure inducing, sedation, orthostatic HTN, CNS depressant, drug interaction w/ CYP 450 enzyme, arrythmias in the heart, cardiac toxicity

Desipramine (Norpramin) & Nortriptyline (Pamelor) are secondary amines; Amitriptyline (Elavil) is a tertiary amine
Tranylcypromine (Parnate)
Phenelzine (Nardil)

Common therapeutic use?
Class?
MOA?
CI?
AEs?
Tranylcypromine (Parnate)
Phenelzine (Nardil)

Indication: Antidepressants, improve mood

Class: MAO inhibitors

MOA: inhibit monoamine oxidase from breaking down monoamines, increase concentrations of DA, NE, SR in synaptic clefts

CI: Lactation

AE: seizures, HTN, headache, abdominal pain ,tinnitus
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)

1st line agents

Common therapeutic use?
Class?
MOA?
Watch for?
AEs?
Which one is FDA approved for anxiety?
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
*Note 3/4 end in -ine"

Indication: Antidepressants

Class: SSRI (Selective serotonin reuptake inhibitor)

MOA: block reuptake of 5HT (serotonin)

Watch for Serotonin syndrome
If stopping med, watch for withdrawal symptoms (agitation, anxiety, sleep/eating pattern change)


AE: Sexual dysfunction, hypothermia, weight gain, N/V/D, bleeding, serotonin syndrome, muscle spasms, confusion,
sweating

paroxetine (Paxil) is FDA approved for anxiety, OCD, panic attacks
Duloxetine (Cymbalta)
Venlafaxine (Effexor)

Common therapeutic use?
Class?
MOA?
Watch for?
AEs?
Duloxetine (Cymbalta)
Venlafaxine (Effexor)

Indication: Antidepressants; Decrease symptoms of depression, anxiety, neuropathic pain. Effexor indicated for "fewer relapses"

Class: SNRI (Selective norepinephrine reuptake inhibitor)

MOA:Inhibit serotonin and NE reuptake in CNS

Watch for: serotonin syndrome

AE: sexual dysfunction, hepatotoxicity, constipation, N/D/V, fatigue, seizure, insomnia, HTN, sweating, dysuria, serotonin syndrome, dry mouth
Nefazodone (Serzone)
Mirtazapine (Remeron)

Common therapeutic use?
MOA?
AEs?
Nefazodone (Serzone)
Mirtazapine (Remeron)

Indication: antidepressant; Decrease depression

MOA: Mixed serotonin and NE reuptake

AE: Seizures, suicide, headache, dry mouth, tremor, N/V
Bupropion (Wellbutrin)

Common therapeutic use?
MOA?
AEs?
Bupropion (Wellbutrin)

Indication: antidepressant; Decrease depression

MOA: Acting through DA, blocks DA reuptake at receptors

AE: Seizures, suicide, headache, dry mouth, tremor, N/V

Also marketed as Zyban for smoking cessation