sedatives + antianxiety

Question 1

what do sedatives do?

Answer 1

depress CNS function

Question 2

what are sedatives used for?

Answer 2

anxiety and insomnia

Question 3

many of the same drugs are used for anxiety and insomnia. whats the difference?

Answer 3

dosage!
lower dose= anxiety
higher doses= insomnia

Question 4

what is the drug of choice for hypnotics?

Answer 4

benzos

Question 5

benzo prototype

Answer 5

triazolam (halcion)

Question 6

other benzos to know (4)

Answer 6

lorazepam (Ativan)
Diazepam (valium)
alprazolam (Xanax)
Midazolam (Versed)

Question 7

MOA of benzos

Answer 7

potentiate GABA, make endogenous gaba go further!

Question 8

what schedule are benzos?

Answer 8

schedule 4

Question 9

what is triazolam (benzo) primarily used for?

Answer 9

sleep! increases total amount of sleep time. tolerance develops slowly, no rebound if you stop.

Question 10

benzo AE on CNS

Answer 10

sedation, confusion, anterograde amnesia, drowsiness, sleep-driving

Question 11

benzo AE on CV

Answer 11

oral- little to no effect

IV- profound HYPOTENSION and CARDIAC ARREST

Question 12

benzo AE on respiratory

Answer 12

oral– little to no effect
IV- significant resp. depression if taken in combo with other CNS depressants
can worsen airway obstruction in OSA and COPD

Question 13

benzos and pregnancy

Answer 13

NO WAY!

Question 14

physical dependency and benzos

Answer 14

wean slowly

Question 15

withdrawal and benzos

Answer 15

if on high doses can be severe!

symptoms: panic, paranoia, delirium, HTN, muscle twitches, convulsions

Question 16

antidote for benzos

Answer 16

flumazenil (romazicon)

Question 17

how to admin flumazenil

Answer 17

admin over 15 seconds, repeat Q min, effects last an hour.

won’t help respiratory effects but will help CNS which can help RR

Question 18

benzo-like drugs MOA

Answer 18

act as agonists @ the benzo receptor site on the GABA receptor- chloride channel

Question 19

benzo-like prototype

Answer 19

zolpidem (ambien)

Question 20

zolpidem characteristics

Answer 20

good for falling asleep, ER for staying asleep

Question 21

SE of benzo-like (zolpidem)

Answer 21

sleep driving
daytime drowsiness

no physical dependence/tolerance but do have to wean off

Question 22

drugs to treat anxiety (4)

Answer 22

SSRI
Benzodiazepines
buspirone (buspar)
antihistamine (hydroxyzine)

Question 23

buspirone characteristics

Answer 23

NOT a CNS depressant
NO abuse potential
NO suicide risk
No increased CNS effects with other CNS depressants
NOT for PRN use (takes weeks to use)
NO grapefruit juice

Question 24

Hydroxyzine characteristics

Answer 24

can be taken as scheduled or PRN
no withdrawal, not a controlled substance
also used for insomnia (sedation SE)

Question 25

SE of hydroxyzine

Answer 25

dry mouth, constipation, confusion, dizziness, headache, fatigue, and with long term use– QT prolongation.