PHARMACOLOGY OF ANXIOLYTIC/SEDATIVE-HYPNOTICS Philip G. Janicak, MD Professor of Psychiatry Rush University I. Introduction A) Anxiety is a natural human experience that can be crippling when excessive B) Anxiety often complicates various medical disorders C) Anxiety disorders have a lifetime prevalence of about 30% II. Tables A) Anxiolytics B) Sedative-Hypnotics III. Pharmacodynamics of Anxiolytics and Sedative-Hypnotics A) Overview B) Gamma-amino-butyric acid (GABA) • Function • GABAA – Chloride Ion – BZD complex • BZD receptor types • BZD receptor activity • Non-BZD agents C) Serotonin (5-HT) • Function • 5-HT receptor subtypes • Serotonin agents D) Norepinephrine (NE) • Function • NE receptor subtypes IV. Anxiety-related and Sleep Disorders A) Indications for Antianxiety/Sedative-Hypnotics B) Generalized Anxiety Disorder (GAD) • Represents 50% of anxious patients seen by physicians • Treatment StrategyC) Obsessive-Compulsive Disorder • Symptoms • Treatment Strategy D) Sleep Disorders • Types (dyssomnias; parasomnias) • Treatment Strategy V. Pharmacokinetics, Drug-Interactions and Adverse Effects of Anxiolytics and Sedative-Hypnotics A) Benzodiazepines • Pharmacokinetics • Drug Interactions • Adverse Effects • Dependence B) Buspirone • Pharmacokinetics • Adverse Effects C) Antidepressants (see notes for lecture on antidepressants) VI.
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