Anna Marie E.

Mendiola BSN-2B
ANXIOLYTIC DRUG
Anti-anxiety Agent

- A minor tranquilizer used to relieve anxiety and reduce tension and irritability
- These drugs can only be prescribed by a doctor
- Benzodiazepines are glycoproteins with an affinity for benzodiazepine receptors which act as specific binding sites for gamma aminobutyric acid (GABA), the
major inhibitory neurotransmitter in the CNS

• The GABA receptors are a class of receptors that respond to the neurotransmitter gamma-aminobutyric acid (GABA), the chief inhibitory neurotransmitter
in the vertebrate central nervous system. There are two classes of GABA receptors:

 GABAA receptors are ligand-gated ion channels (ionotropic receptors)- mediators of fast excitatory or inhibitory neurotransmission

 GABAB receptors are G protein-coupled receptors (metabotropic receptors)- influences the activity of a cell indirectly by first initiating
a metabolic change in the cell
- Azapirones (AZPs) are drugs that are used to treat a range of mental health problems, including anxiety disorders, depression and psychosis. They can be used on their own, or along
with another drug (such as an antidepressant)
 MECHANISM OF USUAL DOSE
DRUG INDICATION CONTRAINDICATION ADVERSE EFFECT
ACTION (AVAILABILITY)
Benzodiazepines • acute stress reactions • Short-acting • Contraindicated in • Their use by expectant • For patients under the
• episodic anxiety compounds have a people mothers shortly before age of 60, who have
* Diazepam • fluctuations in median half-life of 1–12 with myasthenia the delivery may result not received narcotic
- Valium generalized anxiety hours. They have few gravis, sleep in a floppy infant analgesics, a dose of 2–
- Antenex • as initial treatment for residual effects if taken apnea, bronchitis and syndrome, with the 3 mg is normally
severe panic and before COPD newborns suffering adequate, but some
*Alprazolam agoraphobia bedtime, rebound • Caution is required from hypotonia, elderly patients may
• for transient or short insomnia may occur when it is used in hypothermia, respond to a dose as
- Xanax
-Aceprax term insomnia upon discontinuation people with lethargy and low as 1 mg. The usual
• alcohol withdrawal and they might cause personality disorders breathing and feeding dose is up to 4 mg,
day time withdrawal or mental retardation difficulties administered by
*Lorazepam
symptoms such as next • Major Depression • Increase risk of cleft intramuscular injection
- Ativan
day rebound anxiety • Pregnancy palate on infants at least two hours prior
- Temesta
with prolonged usage. • Infant • The long-term effects to surgery. If the drug
• Intermediate-acting • Elderly of benzodiazepines and is given intravenously,
*Clonazepam compounds have a benzodiazepine a dose of up to 2 mg
- Klonopin median half-life of 12– dependence in the may be given 15–20
- Rivotril 40 hours. They may elderly can resemble minutes before surgery.
have some residual dementia, • Benzodiazepines should
effects in the first half depression or be administered 30–60
of the day if used as anxiety syndromes minutes before
a hypnotic. Rebound and progressively exposure to the
insomnia, however, is worsens over time anticipated stress.
more common upon Dosage should be
discontinuation of individualized to
intermediate-acting minimize sedation. The
benzodiazepines than normal dose of
longer acting alprazolam is 0.25–0.5
benzodiazepines. mg. The usual dose of
• Long-acting compounds lorazepam is 2–3 mg.
have a half-life of 40– • These agents should
250 hours. They have a not be administered IV
risk of accumulation in to patients in shock,
the elderly and in coma, acute alcohol
individuals with intoxication, or to
severely impaired liver patients who have
function, but they have recently received other
a reduced severity respiratory depressant
of rebound drugs.
effects and withdraw • AVAILABILITY:
al. diazepam has the
lowest tablet strength
of 2 mg and is available
in liquid form allowing
for small dosage
reductions not possible
with more high potency
benzodiazepines. Small
dose reductions cannot
be achieved with high