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NMSP Exam 3 > Pharm: Sedative and Hypnotic Drugs > Flashcards

Pharm: Sedative and Hypnotic Drugs Flashcards

1
Q

Which drugs are the Benzodiazepines?

A

-Am

Alprazolam

Clonazepam

Diazepam

Lorazepam

Midazolam

Temazepam

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2
Q

What drugs are the Non-Benzo BZ1 agonits?

A

Esxopiclone

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3
Q

What drugs are the Benzo antagonists?

A

Flumazenil

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4
Q

Which drugs are the barbiturates?

A

-tal

Pentobarbital

phenobarbital

thiopental

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5
Q

which drug is in a misc. category?

A

buspirone

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6
Q

Which drug is a melatonin agonist?

A

ramelteon

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7
Q

which drug is a dual orexin receptor antagonist?

A

suvorexant

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8
Q

which drug is an antihistamine?

A

doxepin

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9
Q

What are the main clinical uses of sedative-hypnotics?

A

relief of anxiety

insomnia

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10
Q

what is the most prescribed benzo?

A

Alprazolam

also-clonazepam, lorazepam, diazepam, temazepam

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11
Q

What is the MOA for benzos?

A

Work on GABA A receptor to increase frequency of Cl- channel opening

causes a local hyperpolarization, meaning cell is less likely to fire

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12
Q

What is the most common side effect of benzos?

A

drowsiness

elderly are more susceptible while alcoholics and barbiturate abusers are more resistant

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13
Q

What are paradox reactions as caused by benzos?

A

excitement leading to nightmares, hyperactivity, insomnia, agitation, rage, etc.

occur occasionally in elderly or young

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14
Q

Benzos can alter sleep patterns in which way?

A

may cause changes in stages, but is quickly adapted to

Day-time hangover

Rebound insomnia after abrupt d/c

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15
Q

Can dependence to benzos develop?

A

tolerance and psychological dependence-yes

physiologic dependence-less likely

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16
Q

Which class schedule are benzos?

A

Schedule IV

relatively safe compared to barbiturates

17
Q

What are some signs of benzo abuse?

A

confusion, depression, impaired judgment, decreased inhibitions, “act drunk”

altered vision, sedation, drowsiness

18
Q

Diazepam is a substrate of which CYP?

A

CYP3A4

19
Q

What is the main concern of combining benzos and opioids?

A

may result in profound sedation, respiratory depression, coma and death

20
Q

What condition has been associated with IV Midazolam?

A

respiratory depression and arrest, espcially when used for sedation in non-critical care settings

21
Q

What is the MOA of Zolpidem?

Does it carry anxiolytic effects?

Is it safe in pregnancy?

Why is it used?

Forms?

A

similar to benzo’s MOA

Nope

Yep!

Sleep/insomnia

IR, siblingua tablets, oral spray to initiate sleep

ER tablet for maintenance or onset sleep difficulties

22
Q

What are some concerns associated with Zolpidem?

A

complex sleep behaviors like sleepwalking, sleep-driving?!?!, and engaging in other activities while not fully awake

can result in death

can include making/eating food, phone calls, having sex, etc.

23
Q

What is the main concern of flumazenil?

A

this is an antagonist at benzoe sites on the GABA A receptor and is associated with Seizures especially in people who have been on long-term sedation or were treated with TCAs

24
Q

What drug class are classic inducers of CYP3A4?

A

Barbiturates

25
Q

What is the initial treatment for GAD?

then what?

A

CBT

SSRIs

Buspirone

Pregabalin

Benzos

26
Q

What are the best treatments for specific phobias?

A

exposure therapy

CBT

benzos

27
Q

What is the best treatment for separation anxiety?

A

CBT +/- SSRI

28
Q

How should benzos be tapered?

A

decrease by 25-50% every 1-2 weeks over a period of 6-10wks

longer duration of use means higher liklihood of symptoms

can replace a short acting benzo for a long acting benzo, as short acting ones have a higher dropout rate and worse rebound anxiety

29
Q

what is the effect of Flumazenil?

A

blocks the actions of benzos and Zolpidem, but not other sedatives (like ETOH, barbiturates, etc)

30
Q

What is unique about the properties of Midazolam?

A

It is given IV or IM and is water soluble but highly lipid soluble in vivo

NMSP Exam 3 (21 decks)

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