AGENTS, CONTROLLING THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM - Hypnotic drugs Flashcards

1
Q

Hypnotic drugs are used to treat

A

Sleep disorders

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2
Q

Hypnotic drugs should

A

Produce drowsiness, encourage the onset and maintenance of sleep

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3
Q

Which chemical agents are used in the treatment of insomnia?

A
  • Benzodiazepines
  • Imidazopyridines
  • Barbiturates
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4
Q

Select a hypnotic drug, which is a benzodiazepine derivative

A

Flurazepam

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5
Q

Tick a hypnotic agent – a barbituric acid derivative

A

Thyopental

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6
Q

Select a hypnotic drug, which is an imidazopyridine derivative

A

Zolpidem

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7
Q

Which hypnotic agents is absorbed slowly?

A

Temazepam

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8
Q

Which barbiturates is an ultra-short-acting drug?

A

Thiopental

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9
Q

Indicate the barbituric acid derivative, which has 4-5 days elimination half-life

A

Phenobarbital

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10
Q

Indicate the hypnotic benzodiazepine, which has the shortest elimination half-life

A

Triazolam

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11
Q

Which hypnotic drugs is more likely to cause cumulative and residual effects?

A

Phenobarbital

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12
Q

Which hypnotic drugs increases the activity of hepatic drug-metabolizing enzyme systems?

A

Phenobarbital

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13
Q

Hepatic microsomal drug-metabolizing enzyme induction leads to

A

Barbiturate tolerance

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14
Q

True or False. Hypnotic benzodiazepines are more powerful enzyme inducers than barbiturates.

A

FALSE

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15
Q

Indicate the hypnotic drug, which does not change hepatic drug-metabolizing enzyme activity?

A
  • Flurazepam
  • Zaleplon
  • Triazolam
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16
Q

Barbiturates increase the rate of metabolism of

A
  • Anticoagulants
  • Digitalis compounds
  • Glucocorticoids
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17
Q

Which agents inhibits hepatic metabolism of hypnotics?

A

Cimetidin

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18
Q

Which factors can influence the biodisposition of hypnotic agents?

A
  • Alterations in the hepatic function resulting from a disease
  • Old age
  • Drug-induced increases or decreases in microsomal enzyme activities
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19
Q

Which hypnotics is preferred for elderly patients?

A

Temazepam

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20
Q

Which hypnotics is preferred in patients with limited hepatic function?

21
Q

Indicate the mechanism of barbiturate action (at hypnotic doses)

A

Increasing the duration of the GABA-gated Cl- channel openings

22
Q

Imidazopyridines are

A

Selective agonists of the BZ1 (omega1) subtype of BZ receptors

23
Q

Which hypnotic agents is a positive allosteric modulator of GABA-A receptor function?

A
  • Zaleplon
  • Flurazepam
  • Zolpidem
24
Q

Indicate a hypnotic drug - a selective agonist at the BZ1 receptor subtype

25
Which hypnotic agents is able to interact with both BZ1 and BZ2 receptor subtypes?
Flurazepam
26
Indicate the competitive antagonist of BZ receptors
Flumazenil
27
Flumazenil blocks the actions of
Zolpidem
28
Indicate the agent, which interferes with GABA binding
Bicuculline
29
Which agents blocks the chloride channel directly?
Picrotoxin
30
Which agents is preferred in the treatment of insomnia?
Hypnotic benzodiazepines
31
Barbiturates are being replaced by hypnotic benzodiazepines because of
- Low therapeutic index - Suppression in REM sleep - High potential of physical dependence and abuse
32
Which benzodiazepines is used mainly for hypnosis?
Flurazepam
33
Indicate the main claim for an ideal hypnotic agent
- Rapid onset and sufficient duration of action - Minor effects on sleep patterns - Minimal “hangover” effects
34
Which stage of sleep is responsible for the incidence of dreams?
REM sleep
35
During slow wave sleep (stage 3 and 4 NREM sleep)
Somnambulism and nightmares occur
36
All of the hypnotic drugs induce
Decrease the duration of REM sleep
37
Which hypnotic drugs causes least suppression of REM sleep?
Flurazepam
38
Although the benzodiazepines continue to be the agents of choice for insomnia, they have
- The possibility of psychological and physiological dependence - Synergistic depression of CNS with other drugs (especially alcohol) - Residual drowsiness and daytime sedation
39
Hypnotic benzodiazepines can cause
A dose-dependent decrease in both REM and slow wave sleep
40
Which hypnotic benzodiazepines is more likely to cause rebound insomnia?
Triazolam
41
Which hypnotic benzodiazepines is more likely to cause “hangover” effects such as drowsiness, dysphoria, and mental or motor depression the following day?
Flurazepam
42
Indicate the hypnotic drug, which binds selectively to the BZ1 receptor subtype, facilitating GABAergic inhibition
Zolpidem
43
Which statements is correct for zolpidem?
- Causes minor effects on sleep patterns - The risk of development of tolerance and dependence is less than with the use of hypnotic benzodiazepines - Has minimal muscle relaxing and anticonvulsant effects
44
Which agent exerts hypnotic activity with minimal muscle relaxing and anticonvulsant effects?
Zaleplon
45
True or False. Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines in the management of sleep disorders.
TRUE
46
Which hypnotic drugs is used intravenously as anesthesia?
Thiopental
47
Indicate the usual cause of death due to overdose of hypnotics
Depression of the medullar respiratory center
48
Toxic doses of hypnotics may cause a circulatory collapse as a result of
Action on the medullar vasomotor center