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24 Cards in this Set
- Front
- Back
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6 BZD from lecture
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Diazepam
Flurazepam Lorazepam Triazolam Alprazolam Midazolam |
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3 Barbs from lecture
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Amobarbital
Phenobarbital Thiopental |
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Only barb still used to tx anxiety
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Thiopental
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MOA of BZD and Barbs (5 steps)
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Bind
Allosteric Change Potentiate GABA binding Opens Cl channel hyperpolarization blunts AP |
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Why is single agent BZD OD rarely lead to respiratory depression and death
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BZD's are GABA dependent unlike barbs
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Antagonist BZD binding site
clinical use |
Flumazenil
BZD OD (not for barb or EtOH) |
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ADME of BZD
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Lipophilic
90% bioavailable readily distributed Hepatic metab |
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Which BZD are IV/IM
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Diazepam
Lorazepam Midazolam |
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2 Long acting BZD
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Diazepam
Flurazepam |
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4 Short/Intermediate acting BZD
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Lorazepam
Alprazolam Triazolam Midazolam |
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Clinical use of Diazepam
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Anxiety disorder
Sk. m. relaxant |
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DOC
Insomnia - trouble FALLING asleep Goal: “no”hangover |
Triazolam
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DOC
Insomnia --Trouble STAYING asleep |
Flurazepam
No rebound insomnia after discontinuation |
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Midazolam Clinical use
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Pre and peri-operative sedative
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Good drug for either Panic attacks or General Anxiety Disorder
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Alprazolam
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Good for General Anxiety Disorder
Not for panic attacks |
Lorazepam
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AE's of BZD (7)
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Rebound Insomnia
Ataxia Daytime Drowsiness MEMORY LOSS Confusion in the elderly Blurred Vision HypoTN and Constipation |
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Tolerance to BZDs
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Tolerance to sedative and hypnotic affects
Cross tolerance w/ barbs and EtOH NOT to anxiolytic affects |
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Barbs DOA
Ultra-Short--Short---Long Acting |
Ultra short-- --Short-----------Long
Thiopental--Amobarbital--Phenobarbital |
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MOA
Buspirone |
Anxiolytic
5HT-1a Receptor Agonist |
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MOA
Zolpidem (Ambiem) |
Sedative
Novel GABAergic |
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MOA
Ramelteon |
Sedative
MT1/MT2 Receptor Agonist in the Suprachiasmatic nucleus MT=melatonin |
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DOC
Anxiolytic for Elderly |
Buspirone
(less interference with motor fxn than Alprazolam) |
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DOC
Performance Anxiety and its MOA |
Propranolol
Beta-Blocker |
