Which of the following two classes of medications should be avoided for anxiolysis in patients with asthma?

Barbiturates should be avoided for anxiolysis in patients with asthma primarily due to their potential respiratory depressant effects. These medications can induce airway reactivity in susceptible individuals, potentially leading to bronchospasm or exacerbating existing asthma symptoms. Additionally, barbiturates may negatively impact ventilatory drive, which is critical for patients with pre-existing respiratory conditions like asthma.

In considering treatment options for patients with anxiety and asthma, it is essential to select medications that minimize the risk of respiratory compromise. Other classes, such as benzodiazepines, are often used cautiously, as they may have muscle relaxant properties that could theoretically yield some complications in sensitive patients, though they are typically considered safer than barbiturates in this context. Antipsychotic medications and narcotics can also have side effects that could be detrimental, however, the severe respiratory depression associated with barbiturates makes them particularly problematic for patients with asthma.

Thus, when managing anxiety in asthmatic patients, the risk of adverse respiratory effects from barbiturate use necessitates their avoidance.