14C

Antianxiety Agents
USES

Treatment of anxiety including generalized anxiety disor-
der (GAD), panic disorder, obsessive-compulsive disor-
der (OCD), social anxiety disorder (SAD), posttraumatic
ACTION
Benzodiazepines are the largest and most frequently
prescribed group of antianxiety agents. The exact mecha-
nism is unknown, but they may increase the inhibiting
effect of gamma-aminobutyric acid (GABA), which inhib-
stress disorder (PTSD), and acute stress disorder. In ad-
dition, some benzodiazepines are used as hypnotics, an-
ticonvulsants to prevent delirium tremors during alcohol
withdrawal, and as adjunctive therapy for relaxation of
its nerve impulse transmission by binding to specific
benzodiazepine receptors in various areas of the central
nervous system (CNS).
Antianxiety Agents
skeletal muscle spasms. Midazolam, a short-acting benzo-
diazepine, is used for preop sedation and relief of anxiety
for short diagnostic/endoscopic procedures (see individ-
ual monograph for midazolam).
â•›â•›ALERTâ•› Refer to individual entries of nonbenzodiazÂ�
epine drugs for more information on uses and actions.

ANTIANXIETY AGENTS
Dosage Range
Name Availability Uses (per day) Side Effects
Benzodiazepine
Alprazolam (Xanax) T: 0.25 mg, 0.5 mg, 1 mg, 2 mg Anxiety, panic disorder 0.75–10 mg Drowsiness, weakness, fatigue,
S: 0.5 mg/5 ml, 1 mg/ml ataxia, slurred speech, confusion,
ER: 0.5 mg, 1 mg, 2 mg, 3 mg lack of coordination, impaired memory,
ODT: 0.25 mg, 0.5 mg, 1 mg, 2 mg paradoxical agitation, dizziness, nausea
Chlordiazepoxide C: 5 mg, 10 mg, 25 mg Anxiety, alcohol 5–100 mg Drowsiness, fatigue, ataxia, memory
(Librium) T: 10 mg, 25 mg withdrawal impairment
I: 100 mg
 Clorazepate C: 3.75 mg, 7.5 mg, 15 mg Anxiety, alcohol 7.5–90 mg Hypotension, drowsiness, fatigue,

(Tranxene) SD: 11.25 mg, 22.5 mg withdrawal, ataxia, memory impairment, headache,
anticonvulsant nausea
Diazepam (Valium) T: 2.5 mg, 5 mg, 10 mg Anxiety, alcohol 2–40 mg Hypotension, ataxia, drowsiness,
S: 5 mg/5 ml, 5 mg/ml withdrawal, fatigue, vertigo
I: 5 mg/ml anticonvulsant,
muscle relaxant
Lorazepam (Ativan) T: 0.5 mg, 1 mg, 2 mg Anxiety 0.5–10 mg Sedation, respiratory depression, ataxia,
S: 2 mg/ml dizziness, headache
I: 2 mg/ml, 4 mg/ml
Nonbenzodiazepine
Buspirone (BuSpar) T: 5 mg, 10 mg, 15 mg, 30 mg Anxiety 7.5–60 mg Dizziness, light-headedness, headaches,
nausea, restlessness
Hydroxyzine T: 10 mg, 25 mg, 50 mg, 100 mg Anxiety, rhinitis, 100–400 mg Drowsiness; dry mouth, nose, and throat
(Atarax, Vistaril) pruritus, urticaria,
nausea or vomiting
Paroxetine (Paxil) S: 10 mg/5 ml Anxiety, depression, 10–50 mg Drowsiness, dry mouth, nose, and
T: 10 mg, 20 mg, 30 mg, 40 mg obsessive-compulsive throat; dizziness; diarrhea; diaphoresis;

Antianxiety Agents
T (CR): 12.5 mg, 25 mg, 37.5 mg disorder, panic disor- constipation; vomiting; tremors
der
Trazodone (Desyrel) T: 50 mg, 100 mg, 150 mg, 300 mg Anxiety, depression 100–400 mg Drowsiness, dizziness, headaches, dry
mouth, nausea, vomiting, unpleasant
taste
Venlafaxine (Effexor) C (ER): 37.5 mg, 75 mg, 150 mg Anxiety, depression 37.5–225 mg Drowsiness, nausea, headaches, dry
T (ER): 37.5 mg, 75 mg, 150 mg mouth
T: 25 mg, 37.5 mg, 50 mg, 75 mg,
150 mg

15C
C, Capsules; CR, controlled-release; ER, extended-release; I, injection; ODT, orally disintegrating tablet; S, solution; SD, single dose; T, tablets.
CLASSIFICATIONS
 16C
Antiarrhythmics
USES ACTION

Prevention and treatment of cardiac arrhythmias, such as
premature ventricular contractions, ventricular tachycar-
dia, premature atrial contractions, paroxysmal atrial
tachycardia, atrial fibrillation and flutter.
The antiarrhythmics are divided into four classes based
on their effects on certain ion channels and/or receptors
located on the myocardial cell membrane. Class I is fur-
ther divided into three subclasses (IA, IB, IC) based on
electrophysiologic effects.
Class I: Blocks cardiac sodium channels and slows
conduction velocity, prolonging refractory period and
decreasing automaticity of sodium-dependent tissue.
Class IA: Blocks sodium and potassium channels.
Class IB: Shortens the repolarization phase.
Antiarrhythmics
Class IC: No effect on repolarization phase, but slows
conduction velocity.
Class II: Slows sinus and atrioventricular (AV) nodal
conduction.
Class III: Blocks cardiac potassium channels, prolong-
ing the repolarization phase of electrical cells.
Class IV: Inhibits the influx of calcium through its chan-
nels, causing slower conduction through the sinus and
AV nodes.

ANTIARRHYTHMICS
Name Availability Uses Dosage Range Side Effects
Class IA
Disopyramide C: 100 mg, 150 mg AF, WPW, 400–800 mg/day Dry mouth, blurred vision, urinary retention, HF,
(Norpace, C (ER): 100 mg, 150 mg PSVT, PVCs, proarrhythmia, heart block, nausea, vomiting,
Norpace CR) VT diarrhea, hypoglycemia, nervousness
Procainamide T: 250 mg, 375 mg, 500 mg AF, WPW, A (PO): 250–500 mg q3h; Hypotension, fever, agranulocytosis, SLE,
(Procan-SR, C: 250 mg, 375 mg, PVCs, VT (ER): 250–750 mg q6h headaches, proarrhythmia, confusion,
Pronestyl) 500 mg disorientation, GI symptoms, hypotension
T (SR): 250 mg, 500 mg,
750 mg, 1,000 mg
I: 100 mg/ml, 500 mg/ml