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The stress-response
Published in Herman Staudenmayer, Environmental Illness, 2018
Gamma-amino-butyric-acid is a major central inhibitory neurotransmitter which is pervasive throughout the CNS and has been estimated to reside in about one third of all neural synapses (Enna and Gallagher, 1983). It appears that the effectiveness of benzodiazepine medications (e.g., Valium, Xanax) in mitigating symptoms of anxiety works through activating the inhibitory effects of GABA (File et al., 1979; Insel et al., 1984; Mason and Fibiger, 1979). The stress activation of DA neurotransmission is inhibited by stimulation of GABA and benzodiazepine receptors (Costa, 1985). One implication of this regulatory effect is that DA is also affected if there is a dysregulation of the GABA system. For example, decreased functioning of the GABA system and associated loss of the inhibiting effect over the benzodiazepine system will result in increased symptoms of anxiety.
Psychopharmacology in Aviation
Published in Carrie H. Kennedy, Gary G. Kay, Aeromedical Psychology, 2013
Bradford C. Ashley, Gary G. Kay
The next two popular groups of CNS depressants include the benzodiazepines and barbiturates. These medications are incompatible with flying due to their adverse effects on wakefulness, alertness, and cognitive functioning. Barbiturates are rarely used today except in the treatment of certain types of seizure disorders. Benzodiazepines are a newer class of medications than the barbiturates. Benzodiazepines have proven useful in the short-term management of anxiety and anxiety-related disorders (for example, panic attacks). However, patients treated with benzodiazepines quickly develop tolerance to the medications. To produce the same result higher doses are required over time. These drugs are commonly prescribed in urgent care settings by non-aeromedically trained providers. Therefore aviators need to be educated about the danger associated with these medications. This class of drugs is detected by most drug surveillance programs. A pilot found to be using benzodiazepines or barbiturates is likely to lose his/her license.
Sedation, analgesia and patient observation in interventional radiology
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
Jeffrey E. Quam, Michael A. Bettmann
The primary mode of action of the benzodiazepines is through facilitation of the gamma-aminobutyric acid (GABA) system in the CNS. This system is the largest and most powerful inhibitory system in the brain. Benzodiazepine-binding sites are found throughout the CNS, but are most numerous in the cerebral cortex and least numerous in the spinal cord. Benzodiazepines do not act directly at GABA-receptor sites, but instead enhance the binding of GABA to its receptors.4 This enhances the GABA-mediated conductance of chloride through the cell membrane.5 Through direct GABA potentiation, benzodiazepines enhance the degree of general CNS inhibition.
Evaluating drugged driving: Effects of exemplar pain and anxiety medications
Published in Traffic Injury Prevention, 2018
Timothy L. Brown, Gary Milavetz, Gary Gaffney, Andrew Spurgin
Benzodiazepines, such as alprazolam, become pharmacologically active by modulating effects of the powerful neuroinhibitory neurotransmitter gaba-aminobutyric acid (GABA). Benzodiazapines enhance GABA-receptor sensitivity and responsiveness, thus adding to the inhibitory effects of the most widespread inhibitory neurotransmitter system in the CNS. There are 4 major receptor subtypes in the CNS (α, γ, β, δ) and there are receptor subunits within these subtypes. Pharmacological actions of benzodiazepines, predominately through the α receptors, induce sedation, anxiolysis, amnesia, myorelaxation, motor impairment, and anticonvulsant activity, The neuromoduating inhibitory effects of the benzodiazepine receptors, as well as the widespread neuroanatomical locations of GABA, suggest neurophysiological mechanisms of action by which alprazolam could affect the cognitive and motor actions involved in driving a motor vehicle. Hypothesized psychological and physiological components of driving include alertness; sensory–perceptual processing, reaction time and psychological processing; memory; executive functioning; and motor coordination. Benzodiazepines could be implicated in any of those levels of cognitive and psychomotor processing. Alprazolam clearly produces powerful CNS effects, including drowsiness, impaired concentration, impaired executive functioning, as well as possible effects peripherally, including loss of motor coordination.
The EcoScale as a framework for undergraduate green chemistry teaching and assessment
Published in Green Chemistry Letters and Reviews, 2018
Andrew P. Dicks, Andrei Hent, Katherine J. Koroluk
The three catalysts assigned to students (one to each student) were sulfanilic acid, zirconyl(IV) chloride octahydrate and sulfamic acid. This reaction additionally had the advantage of being “real-world relevant” and of interest to undergraduates, as benzodiazepines are central nervous system depressants producing anti-anxiety, anticonvulsant, hypnotic and sedative effects. Common anti-anxiety medications such as diazepam (Valium®), lorazepam (Ativan®) and alprazolam (Xanax®) are classified as benzodiazepines.
Evaluation of medical students’ knowledge of psychoactive substances in the context of their future role in addiction prevention and therapy
Published in The New Bioethics, 2021
Katarzyna Góralska, Weronika Gawor, Szymon Lis, Michał Oszczygieł, Adam Boroński, Ewa Brzeziańska-Lasota
In our research, respondents showed little knowledge about the symptoms of opioid addiction, which is significant because many opioids are used in the treatment of chronic pain. Epidemiological research indicates that up to 42% of people over 65 years old in Poland suffer from chronic pain (Kozak-Szkopek et al.2017). In the European Union, opioid treatment was required by about 25% of elderly people, while in Brazil, it is required by up to 80% (Skare et al.2010, Langley 2011). In many populations, opioid drugs were overused. The treatment of chronic pain should start with non-opioid drugs; physicians should use weak and then strong opioids only if non-opioid drugs are shown to be ineffective (Dowell et al.2016, Volkow and McLellan 2016). Prescribing and monitoring opioid drugs requires a much clinical knowledge and experience. Patients undergoing treatment should be kept under strict control. Primary care physicians are responsible for initiating chronic pain management. Unfortunately, many physicians lack experience in this area and ignore the need to manage patient pain appropriately (O’Brien et al.2017). Long-term treatment with prescribed medicines (e.g. opioids or benzodiazepines) can lead to drug dependence or addiction. In the case of opioid use, an increased risk of dependence was observed with a high initial dose, high pain intensity, treatment longer than 90 days and concomitant use of benzodiazepines. Benzodiazepine dependence itself has been found to be higher in Caucasians, especially in lower income groups, and in those taking two or more of these types of drugs concurrently (Taylor et al.2019). Therefore, doctors should have extensive knowledge about the possibility of dependence and addiction from prescribed drugs and very carefully monitor the patient's condition during treatment with psychoactive substances. The use of such prescribed drugs is increasing rapidly. In the UK, from 2008 to 2018, the use of antidepressants more than doubled (Taylor et al.2019).