Antianxiety

Antianxiety agents Antiaiis toxicaiia An ti air hy thnu c Antiairhythnnc agents Antiaithritics Antiasthmatic agents... 

Anxiolytics are compounds that act primarily to refleve the symptoms of anxiety although such agents can also be used as anticonvulsants, sedatives, hypnotics, and anesthetic agents (see Anesthetics). The principal class of anxiolytics, the BZs, shows dependence HabiUty (5) whereas newer agents such as buspkone [36505-84-7] and ritanserine [8705-43-2] produce antianxiety effects via central serotoninergic systems (6). 

Ethanol (1) is the most widely used antianxiety agent. In the 1950s, the pioneering work of Berger on the muscle relaxant mephenesin [59-47-17, (71), led to the identification of meprobamate (24) as an effective agent for the treatment of anxiety. 

Sales for hypnotic—sedative agents ia the United States for 1993 were estimated to be 139,000,000. Anticonvulsant sales for 1993 were estimated at 525,000,000. U.S. sales of antianxiety agents including both the BZs and buspirone-hke agents for 1993 were estimated at 1,046,000,000. 

Benzodiazepines as antianxiety agents, 1, 170 as anticonvulsants, 1, 166 organometallic complexes, 7, 604 as sedatives, 1, 166 IH- 1,2-Benzodiazepines conversion to 3H-1,2-benzodiazepines, 7, 604 synthesis, 7, 597, 598, 604 3H-1,2-Benzodiazepines acid-catalyzed reactions, 7, 601 nucleophilic reactions, 7, 604 oxidation, 7, 603 synthesis, 7, 596 thermal reactions, 7, 600 5H-1,2-Benzodiazepines photochemical reactions, 7, 599 synthesis, 7, 603... 

Problem 6.3 Diazepam, marketed as an antianxiety medication under the name Valium, has three rings, eight double bonds, and the formula C]6H/CIN20. How many hydrogens does diazepam have (Calculate the answer don t count hydrogens in the structure.)... 

Chlorine and iodine can be introduced into aromatic rings by electrophilic substitution reactions, but fluorine is too reactive and only poor yields of monofluoro-aromatic products are obtained by direct fluorinafion. Aromatic rings react with CI2 in the presence of FeCl3 catalyst to yield chlorobenzenes, just as they react with Bi 2 and FeBr3. This kind of reaction is used in the synthesis of numerous pharmaceutical agents, including the antianxiety agent diazepam, marketed as Valium. 

To speed the process of drug discovery, combinatorial chemistry> has been developed to prepare what are called combinatorial libraries, in which anywhere from a few dozen to several hundred thousand substances are prepared simultaneously. Among the early successes of combinatorial chemistry is the development of a benzodiazepine library, a class of aromatic compounds much used as antianxiety agents. 

Tranquilizers (also called antianxiety drugs) are used to treat a variety of psychiatric disorders which go along with anxiety (anxiety disorders). Serotonin-reuptake inhibitors and the benzodiazepines are the most commonly employed drugs for the treatment of common clinical anxiety disorders. 

The exact mode of action of diazepam (Valium), an antianxiety drug (see Chap. 30), in die relief of painful musculoskeletal conditions is unknown. The drug does have a sedative action, which may account for some of its ability to relieve muscle spasm and pain. 

Although the use of barbiturates and miscellaneous sedatives and hypnotics for sedation has largely been replaced by the antianxiety drugs (see Chap. 30), they occasionally may be used to provide sedation before certain types of procedures such as cardiac catheterization or the administration of a local or general anesthesia Sedative doses usually given during daytime hours, may be used to treat anxiety and apprehension. Fhtients with chronic disease may require sedation, not only to reduce anxiety, but also as an adjunct in the treatment of their disease... 

Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient taking antianxiety drugs. 

Discuss ways to promote an optimal response to therapy, how to mange common adverse reactions, and important points to keep in mind when educating patients about the use of antianxiety drugs. 

Discuss the uses, general drug actions, general adverse reactions, contraindications, precautions, and interactions associated with the administration of the antianxiety drugs. 

The antianxiety dragp are discussed in this chapter. Antidepressant dragp and antipsychotic drugs are discussed in Chapters 31 and 32, respectively. 

Antianxiety drugp include the benzodiazepines and the nonbenzodiazepines. Examples of the benzodiazepines... 

Antianxiety drugp are used in the management of anxiety disorders and short-term treatment of the symptoms of anxiety. Long-term use of these dru is usually not recommended because prolonged therapy can result in drug dependence and serious withdrawal symptoms. 

Some of these drugp may have additional uses as sedatives, muscle relaxants, anticonvulsants, and in the treatment of alcohol withdrawal. For example, clo-razepate (Tranxene) and diazepam (Valium) are used as anticonvulsants (see Chap. 28). Additional uses of the individual antianxiety drugp are given in the Summary Drug Table Antianxiety Drugp. 

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