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| Pregunta | Respuesta |
| What is anxiety? | Anticipation of fear in the absence of external stimuli |
| What is an anxiolytic? | Takes a state of increased arousal back to normal |
| What is a sedative? | Takes nervous system from normal level to lower (i.e. for surgery) |
| What is a hypnotic? | Takes nervous system from normal level and dampens down even further, sends individual to sleep |
| What classes of drugs can be used as anxiolytics? (6) | Antidepressants Benzodiazepines 5-HT1a receptor agonists Some antiepileptic drugs Anti-psychotics B-adrenoreceptor agonists |
| Which class of drugs can be used to subdue a panic attack but shouldn't be used long term due to their addictive nature? | Benzodiazepines |
| Which drugs are anxiolytic, sedative and hypnotic? | Benzodiazepines Zopiclone (Potentiates GABAa) Barbituates |
| Which drugs are just anxiolytic? | Antidepressants Buspirone B adrenoreceptor antagonists (eg propanolol) |
| Which drug is just hypnotic? | Antihistamine |
| What are the two mainly used types of anti-depressants? | SSRIs (Selective serotonin re-uptake inhibitors) SNRIS (Selective noradrenaline re-uptake inhibitors) |
| What is the onset time period for anti-depressants? (SSRIs and SNRIs) | 6 weeks |
| Give an example of an SSRI | Citalopram |
| Give an example of a SNRI | Venlafaxine |
| What are the clinical uses of benzodiazepines? | anti-anxiety sedative hypnotic anti-convulsant antieplieptic (some eg diazepam) Muscle relaxant |
| What are the side effects of benzodiazepines? (6) | Drowsiness Amnesia Confusion Impaired motor function Lack of depth perception Reduced REM |
| Give an example of a benzodiazepine used to treat anxiety? | Nitrazepam |
| What happens if you mix benzodiazepines with alcohol? | Respiratory depression |
| What are the half lives of these drugs and what are they (hypnotic, anxiolytic, anticonvulsant) (5) (more important are *) Zolpidem | 1-2h Hypnotic |
| Triazolam | 2-4h Hypnotic |
| Loprazolam | 6-12h Anxiolytic and Hypnotic |
| *NITRAZEPAM | 16-40h Anxiolytic and Hypnotic |
| Diazepam | 10-40h Anticonvulsant & Anxiolytic |
| Tolerance in benzodiazepine is ? in Anticonvulsants Anxiolytics Hypnotics | High Medium Low |
| How does tolerance vary with half life of the drug? | Shorter the half life the less likely tolerance occurs |
| What are the physical dependence withdrawal symptoms? | Anxiety Dizziness Tremor Tinnitus Weight loss Sleep disturbances |
| How do benzodiazepines work? (2) | 1) Increase affinity of GABA to receptor 2) Increase probability of channel opening |
| What effect does BCCE (ethyl-B-carboline-3-carboxylate) and diazepam binding inhibitors have? | Cause conformational change to GABA receptor making it harder for benzodiazepines to bind. |
| What is the point of benzodiazepine antagonists? | Reverse effects of benzodiazepines eg. excessive drowsiness |
| What happens if you give someone a benzodiazepine antagonist if they have no benzodiazepines in their system? | Induce anxiety |
| Give an example of a benzodiazepine antagonist | Flumazenil |
| What is phenobarbitone? | Barbituate |
| What type of receptors do barbituates potentiate the action of? | GABAa |
| Which ligand gated ion channel do they inhibit? | AMPA |
| Why are benzodiazepines used more commonly than barbiturates? | Harder to cause anaesthesia and death in overdose when using benzodiazepines |
| How do low and high concentrations of barbiturates interact with GABA receptors? | 1) Low conc. prolong opening of R in presence of GABA 2) High conc. can open receptor without GABA present |
| What is Buspirone | 5HT-1a receptor partial agonist |
| How does Buspirone differ to benzodiasepines in terms of sedation and motor in-coordination? | Less |
| What are the side effects of Buspirone and how do they relate to benzodiazepines? | Headaches Nausea Dizziness Restlessness ALL LESS THAN IN BENZODIAZEPINES |
| What are the pros of Buspirone (1) | 1) No tolerance or physical dependence |
| What are the cons of Buspirone? | 1) Doesn't help withdrawal from Benzos. 2) Takes days to weeks to work but only licensed for short term use 3) Don't help with panic attacks/severe anxiety 4) May increase anxiety initially |
| What are 5-HT1a receptors and where are they located? | Somatodendritic autoreceptors Serotenergic neurons in the Raphe nucleus |
| What effect does the prolonged presence of buspirone have on the 5-HT1a receptors (and seretonin release)? | Initially receptors are activated causing a decrease in seretonin release. Receptors desensitise, seretonin release increases. |
| Why are B adrenoreceptors antagonists not a good anxiety treatment? | Treat symptoms not anxiety itself |
| Which symptoms of anxiety do B adrenoreceptor antagonists treat? | Peripheral symptoms - Palpitations Sweating Tremor |
| Give an example of an B adrenoreceptor antagonist | Propanolol |
| What can antipsychotics be used to treat? | GAD, PTSD |
| Why are antipsychotics not generally used? | Greater incidence of side effects than other anxiolytics |
| What can zopiclone and zolpidem be used for? | Insomnia treatment |
| Where do Zopiclone and zolpidem bind? | Same place and benzodiazepines (ay interface) |
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