Sedative Hypnotics and Anti-Anxiety Drugs

Question 1

What do sedative or antianxiety agents cause?

Answer 1

Reduce anxiety w.o causing sleep.

Question 2

What do hypnotic agents cause?

Answer 2

Physiologic sleep

Question 3

Barbiturates are what kind of depressants?

Answer 3

CNS

Question 4

Types of barbiturates.

Answer 4

1) Sodium Thiopental (general anesthesia)
2) Pentobarbital
3) Phenobarbital (epilepsy)

Question 5

Use of barbiturates:

Answer 5

General anesthesia, epilepsy, euthanasia, capital punishment.

Question 6

This drug class has replaced barbiturates bc they have a lower risk of overdose.

Answer 6

Benzodiazepines.

Question 7

These are rarely ever indicated in modern sedation.

Answer 7

Barbiturates.

Question 8

What determines barbiturate onset of action?

Answer 8

Lipid solubility.

The more soluble lipid soluble the barbiturate, the faster it gets into the CNS, and the faster it redistributes to adipose cells (so the shorter it’s duration of action).

Question 9

Highly lipid soluble barbiturates.

Answer 9

Thiopental and Pentobarbital

Question 10

Less lipid soluble barbiturate, so it has a slower onset of action, and longer duration.

Answer 10

Phenobarbital

Question 11

Barbiturate MOA

Answer 11

Increase GABA binding.

Question 12

These barbiturates are used for lethal injection.

Answer 12

Intermediate-acting barbiturates.

Question 13

MOA of Benzodiazepines

Answer 13

Allosteric modulators of the GABA-A Receptor that increase the amount of GABA receptors that are open to bind GABA.

Increases GABA binding.

Question 14

The major inhibitory NT in the CNS.

Answer 14

GABA

Question 15

______ and __________ are positive allosteric modulators- they potentiate neuronal inhibition by GABA.

Answer 15

Benzodiazepines; non-benzodiazepines.

Question 16

The effects of Benzodiazepines (Anxiolysis, sedation, hypnosis) are ______________.

Answer 16

Dose-dependent.

Question 17

What are Benzodiazepines used for?

Answer 17

1) Anti-anxiety
2) Sedation-hypnosis
3) Anti-epileptic
4) Muscle relaxant

Question 18

Sedation causes _______.

Hypnosis causes _______.

Answer 18

drowsiness; sleep

Question 19

Benzodiazepines end in ___.

Answer 19

Azolam or Azepam

Question 20

Short-acting Benzodiazepines that are used in sedation dentistry.

Answer 20

Midazolam and Triazolam

Question 21

Intermediate-acting Benzodiazepines.

Answer 21

Lorazepam

Question 22

Long-acting Benzodiazepine

Answer 22

Diazepam

Question 23

Flumazenil is used for what?

Answer 23

To reverse Benzodiazepine overdose.

Question 24

Half-life of Flumazenil.

Answer 24

40-80 minutes, so patients should be monitored for “resedation” and respiratory depression from persistent BDZ effects.

Question 25

These drugs have proven effective as rapid-onset and short-acting sedatives that are safe at the recommended doses.

Answer 25

Hypnotic Benzodiazepine-like drugs (Z-Drugs)

Question 26

Z drugs are __________-________ and are sedative-hypnotic.

Answer 26

Benzodiazepine-like

Question 27

Why are Z drugs benzodiazepine-like?

Answer 27

Bc they bind to GABA-A receptors to increase GABA binding.

Question 28

Flumazenil can be used to treat overdoses by which drug?

Answer 28

BDZ’s and Z-drugs.

Question 29

Non-prescription anti-histamines that can be used as sedatives.

Answer 29

Diphenhydramine
Hydroxyzine
Promethazine

Question 30

A weak opioid that can be used for pedo sedation.

Answer 30

Meperidine.

Question 31

Triple Combo Sedation Cocktail for Pediatric Dentistry.

Answer 31

Chloral hydrate
Hydroxyzine
Meperidine

Question 32

This drug does not promote physical dependence and associated withdrawal symptoms upon cessation (unlike bars, BDZ’s, and Z-drugs)

Answer 32

Buspirone