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Benzodiazepine Sedative Hypnotics Anxiolytics

Benzodiazepine sedative hypnotics anxiolytics: (pam and lam suffix) Action= increases GABA; causes sedation and can lead to dependence ANTICHOLINERGIC EFFECTS- NO 3S's Don't take w alcohol, high potential for abuse and taper off B-no Booze A-Abuse E- encrementally taper off Alprazolam- Diazepam- Lorazepam- Chlordiazepoxide- Clonazepam- Oxazepam- Antihistamine: A ANTICHOLINERGIC EFFECTS- NO 3S's Hydroxyzine- potent and highly-selective histamine inverse agonist Atypical Anxiolytics: Buspirone- Inc serotonin, dizziness, insomnia, ANTICHOLINERGIC EFFECTS- NO 3S's SSRIs (selective serotonin reuptake inhibitors): pram, tine S- suicide risk S- slow onset, taper off SEROTONIN SYNDROME: S-sweaty and hot (fever) R- rigid muscles- hyperreflexia, restlessness, agitation, confusion, hallucinations I- increased HR and BP (tachycardia) (hypertension) Action= inhibits reuptake of serotonin (therefore serotonin IvIs inc) AE= wt gain, sexual dysfunction, insomnia, Never mix SSRIs w St Johns wort, or MAOIs!!! Paroxetine- Sertraline- Citalopram- Escitalopram- Fluoxetine- Fluvoxamine- SNRIs (serotonin-norepinephrine reuptake inhibitors): VDD Action= increase levels of norepi and 5HT and serotonin AE= Venlafaxine. Duloxetine- DUAL purpose- depression and px Desvenlafaxine- Clonidine/propranolol- used for sx control, any physical manifestations of anxiety; inc HR, palpitations Flumazenil: reversal for benzos