IA Anxiolytics, Hypnotics and Barbiturates

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Questions and Answers

What is a significant risk associated with the concurrent use of MAOIs and buspirone?

Serotonin syndrome (correct)

Increased effectiveness of buspirone

Heightened sedation

Development of anxiety disorders

Which of the following is contraindicated for use with buspirone?

Benzodiazepines

Acetaminophen

Enalapril

Monoamine oxidase inhibitors (MAOIs) (correct)

Which of these medications can be safely used concurrently with buspirone?

Vitamin C (correct)

Selective serotonin reuptake inhibitors

Monoamine oxidase inhibitors (MAOIs)

Tricyclic antidepressants

What is the primary concern when combining buspirone with benzodiazepines?

No specific contraindications exist Signup and view all the answers

Which statement regarding the use of enalapril with buspirone is accurate?

Enalapril can be used safely with buspirone Signup and view all the answers

What is the primary use of alprazolam?

Management of acute panic attacks Signup and view all the answers

Which medication is considered a first-line treatment for panic disorder in patients with comorbid depression?

Buspirone Signup and view all the answers

Which of the following statements about triazolam is correct?

It is primarily prescribed for short-term insomnia treatment. Signup and view all the answers

What is a significant contraindication for alprazolam?

Myasthenia gravis Signup and view all the answers

Which medication enhances the activity of GABA via selective agonism at the BZ1 receptor?

Zolpidem Signup and view all the answers

Which of the following medications is primarily used for inducing relaxation and sleep?

Secobarbital Signup and view all the answers

What is a common side effect associated with benzodiazepines like alprazolam?

Drowsiness Signup and view all the answers

Which mechanism describes the action of buspirone?

Partial agonist at brain 5-HT1A and 5-HT2 receptors Signup and view all the answers

What is the most commonly reported adverse reaction to alprazolam?

Drowsiness Signup and view all the answers

Which medication is used specifically as an antidote for benzodiazepine overdose?

Flumazenil Signup and view all the answers

Which mechanism of action describes flumazenil?

Competitively inhibits at the benzodiazepine receptor site Signup and view all the answers

Which of the following is NOT used as an antidote for benzodiazepine overdose?

Oxazepam Signup and view all the answers

Which medication could potentially lead to the recurrence of benzodiazepine dependence?

Amobarbital Signup and view all the answers

Which drug is a selective serotonin reuptake inhibitor (SSRI)?

Fluoxetine Signup and view all the answers

Which of the following is true about buspirone?

It is effective for generalized anxiety disorder. Signup and view all the answers

Which of these medications is commonly prescribed for insomnia?

Tasimelteon Signup and view all the answers

What is a major risk associated with amobarbital use?

Dependency and overdose Signup and view all the answers

What is the action of naloxone?

Antagonizes opioid receptors Signup and view all the answers

Which medication is known for managing insomnia without the risk of benzodiazepine dependence?

Zolpidem Signup and view all the answers

What distinguishing feature does tasimelteon have among sleep medications?

Agonizes melatonin receptors Signup and view all the answers

Which statement is true regarding the side effects of zolpidem?

It causes drowsiness. Signup and view all the answers

What effect does buspirone have on serotonin receptors?

Is a partial agonist at serotonin receptors. Signup and view all the answers

Study Notes

Benzodiazepines vs Non-Benzodiazepines for Anxiety and Insomnia

Alprazolam is a benzodiazepine commonly used for acute management of panic attacks due to its rapid onset of action and anxiolytic effects.
Triazolam is a benzodiazepine used for short-term treatment of insomnia. It is not typically used for panic attacks.
Zolpidem is a non-benzodiazepine used primarily for insomnia treatment. It is not indicated for panic attacks.
Buspirone is a second-line treatment option for panic disorder.
- It is considered first-line in patients with comorbid depression or substance abuse, or those at risk for benzodiazepine dependence.
- Does not interact with fluoxetine and can be safely used in patients receiving SSRI treatment.
- Onset of action is prolonged so it is not indicated for acute attacks.
Secobarbital is a barbiturate medication with sedative effects. While it may induce relaxation and sleep, it is not commonly used for panic attacks due to the risk of dependence and overdose.

Mechanisms of Action

Alprazolam binds in the chloride ion channel between α1 and γ subunits, increasing the affinity of GABA and increasing the frequency with which the channel opens.
Orexin antagonists block the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R, which is thought to suppress wake drive.
Zolpidem enhances the activity of γ-GABA via selective agonism at the BZ1 receptor.
Buspirone is a partial agonist at brain 5-HT1A and 5-HT2 receptors. It also has moderate affinity for brain dopamine D2 receptors.
Secobarbital binds to specific GABAA receptor subunits at CNS neuronal synapses, facilitating GABA-mediated chloride ion channel opening duration.

Contraindications

Alprazolam is contraindicated in patients with myasthenia gravis, as benzodiazepines can exacerbate muscle weakness, potentially leading to respiratory depression.

Common Adverse Reactions

Drowsiness is a common adverse reaction to benzodiazepines like alprazolam, especially shortly after administration.
Pain at the injection site is not typically associated with alprazolam, as it is usually administered orally.
Behavioral problems are not commonly reported adverse reactions to alprazolam, but are more associated with clonazepam administration.
Arrhythmia is not a common adverse reaction associated with alprazolam.
Diarrhea is not a common adverse reaction to alprazolam.

Antidotes

Flumazenil is a benzodiazepine receptor antagonist used as an antidote for benzodiazepine overdose.
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant and is not used as an antidote for benzodiazepine overdose.
Oxazepam is a benzodiazepine medication used to treat anxiety and alcohol withdrawal symptoms. It is not used as an antidote for benzodiazepine overdose.
N-acetylcysteine is used as an antidote for acetaminophen overdose and is not effective for benzodiazepine intoxication.
Naloxone is an opioid receptor antagonist used to reverse opioid overdose and is not effective for benzodiazepine intoxication.

Insomnia Treatment Options

Flumazenil is not used to promote sleep and may not be suitable for patients with a history of benzodiazepine dependence.
Tasimelteon is a melatonin receptor agonist used to regulate the sleep-wake cycle in individuals with non-24-hour sleep-wake disorder. It is not typically used for primary insomnia or as a sleep aid in general.
Amobarbital is a barbiturate medication with sedative effects and not commonly used for insomnia due to its high potential for tolerance, dependence, and overdose.
Naloxone is an opioid receptor antagonist used to reverse opioid overdose and not used to promote sleep.
Zolpidem is a non-benzodiazepine sedative-hypnotic medication used to treat insomnia by promoting sleep onset. It is often preferred in cases where benzodiazepines are not desired due to its shorter half-life and lower risk of dependence.

Drug Interactions

Concomitant use of MAOIs (monoamine oxidase inhibitors) with buspirone can lead to serotonin syndrome, a potentially life-threatening condition. Therefore, combining buspirone with MAOIs is contraindicated.
There are no specific contraindications for the concurrent use of benzodiazepines with buspirone.
There are no known contraindications for the concurrent use of buspirone with:
- vitamin C
- acetaminophen
- enalapril

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Description

Test your knowledge on the different medication classes used for anxiety and insomnia. This quiz covers benzodiazepines like Alprazolam and Triazolam, as well as non-benzodiazepine options like Zolpidem and Buspirone. Understand their uses, indications, and interactions to enhance your awareness of anxiety treatment options.