CNS drugs- HYPNOTICS

Question 1

classification of hypnotics

Answer 1

• Benzodiazepines
  
  • Temazepam-tab 10mg
  • Midazolam- tab 15mg
• Barbiturates
  
  • Phenobarbital tab 100mg
  • Cyclobarbital-tab 200mg
• Benzodiazepine like drugs
  
  • Zolpidem –tab 5mg, 10mg
  • Zopiclon-tab 7.5mg
• H1 blockers-1st gen
  
  • Dipenhydrinate-tab 50 mg
  • Promenthazine
• Melatonin:
  
  • Ramelteon 8mg tablets

Question 2

calssification of sedatives

Answer 2

SEDATIVES:
Bromide salts:
Ca bromide- amp 4%5ml

Mg salts
Mg sulphate- amp 50%10ml

Herbal prep:
Valerian extract
Validol- subling tab 60mg

Question 3

list benzodiazapenes

Answer 3

Temazepam-tab 10mg

Midazolam- tab 15mg

Lorazepam

Question 4

pharmacokinetics of benzo’s

Answer 4

absorption: good oral abs

• RAPID-MIDAZOLAM
• imdt - temazepam
• s l o w- l o r a z e p a m

distro

• Well distributed, Highly bound to plasma proteins
• Cross BBB (reaches brain) and PB(reaches gonads)

metabolism

• liver metabolism w/ ACTIVE METABOLITES

Excretion = URINE

Question 5

pharmacodynamics of benzo’s ( how they produce their effect on the boddy)

Answer 5

Agonists of GABA and increase ots inhibitory effect n the brain causing

1. Hypnotic action- that DOESN’T suppress REM sleep
2. Anxiolytic activity

Question 6

what are benzo’s used for in clinical practice

Answer 6

• Treatment of insomnia
• Treatment of anxiety disorders
• Treatment of epilepsy
• Treatment of skeletal muscle spasms
  *

Question 7

antidote of benzo’a

Answer 7

FLUMAZENIL

Question 8

adr’s of benzo’s

TAAD

Answer 8

1. Tolerance
2. Ataxia
3. Anteretrograde amnesia
4. Physical and psychological dependence

Question 9

contraindications of benzo’s

Answer 9

1. Obstructive sleep apnea
2. Pregnancy

Question 10

what drugs do benzo’s interact with

Answer 10

increace effects of CNS depressants

drugs that inhibit the function of the central nervous system (CNS). Alcohol impairs and slows both physical and psychological activity. Other drugs that fit into the depressant category include sedatives, tranquilizers and anesthetics.

Don’t take with alcohol

Question 11

list some barbiturates

Answer 11

Phenobarbital tab 100mg
Cyclobarbital-tab 200mg

Question 12

Pharmokinetics of barbiturates

Answer 12

Absorption: good oral
Distrubution:

• barbs dirstibute throughout body. they are
• Short acting and redistribute from brain to skeletal muscle

Question 13

effect of barbs on the body

Answer 13

• Interact with GABA A receptors and enhance GABAergic transmission
• Block excitatory glutamate receptors
  
  • this causes them to have a narrower effective range than benzo’s as they cause ADR’s at lower doses

Question 14

Clinical uses of barbs

Answer 14

• Insomia: not recommended due to increased risk of side effects of daytime drowsiness
• General aneshesia (ultra short actng)
• Anticonvulsant

Question 15

ADR’S of barbs

low bones

Answer 15

• Low therapeutic index
• Physcial and psychological dependence
• Tolerace
• Rachitis in children osteomalacia in adults