Exam 2; Anti-Anxiety and Hypnotics

Question 1

What are the definitions of anxiolytics, sedatives, and hypnotics

Answer 1

anxiolytics; reduce anxiety
sedatives; induce calmness without drowsiness
hypnotics; induce normal sleep

Question 2

True or False

anxiolytics, sedatives, and hypnotics are all derived to treat diseases

Answer 2

False; they only treat symptoms

Question 3

Most of these drugs target what

Answer 3

GABA; the major inhibitory neuron

**activating the receptor

Question 4

These are the major anti-anxiety drugs; the “‘-pam’s” and “-lam’s” long duration, low dose

Answer 4

benzodiazepines
+ chlorodiazepoxide
The beginning letters; D, A, C, C, O, L

Question 5

These are used primarily for the treatment of insomnia; shorter duration, higher dose

Answer 5

flurazepam
temazapam
estrazolam
Quazepam
triazolam
F, T, E, Q, T

Question 6

This is used in general anesthesia; given IV

Answer 6

midazolam

Question 7

What is the effect of a low dose of benzodiazepines

Answer 7

decrease aggressive behavior and anxiety

Question 8

What is the effect of a high dose of benzodiazepines

Answer 8

sedation and hypnosis
anesthesia
amnesia

Question 9

What kind of mechanisms cause muscle relaxation, involving the benzodiazepines

Answer 9

central and spinal cord mechanisms; anti-spastics

Question 10

benzodiazepines are also used for what

Answer 10

anti-convulsant effects

Question 11

Where are the active benzodiazepine receptor sites on the brain

Answer 11

close to or on the GABA receptor of neurons

not where GABA binds directly

Question 12

What is the activity of benzodiazepine on its receptors

Answer 12

it enhances the effect of GABA on its receptor; makes the receptor more sensitive to GABA

Question 13

What are the two metabolitic paths of benzodiazepines

Answer 13

absorbed from the GI if given orally

metabolized in the liver; not induce P450

Question 14

What causes tolerance of benzodiazepines

Answer 14

down regulation of the benzodiazepine binding sites

Question 15

What could the result be from withdrawal of benzodiazepines

Answer 15

seizures

hyperactivity of the brain due to loss of inhibitory action

Question 16

What is habituation

Answer 16

not the same as addiction

become psychological dependent; you THINK you need it

Question 17

What is the therapeutic index of benzodiazepines

Answer 17

very high; it is virtually impossible to kill yourself with solely these; low toxicity

Question 18

What are five side effects of benzodiazepines

Answer 18

drowsiness
ataxia
impaired judgment
confusion; especially in the elderly
decreased ability to learn new material

Question 19

benzodiazepines can interact with this CNS depressant

Answer 19

ethanol

Question 20

What are two visual disturbances of benzodiazepines

Answer 20

diplopia

nystagmus

Question 21

This is a benzodiazepine receptor blocker; given IV due to 1st pass metabolism

Answer 21

flumazenil

Question 22

These act by binding to α subunits of benzodiazepine receptor

Answer 22

non-benzodiazepine hypnotics

Question 23

What are three non-benzodiazepine hypnotics

Answer 23

zolpidem
zaleplon
eszopiclone
the “z” drugs

Question 24

What are four behavioral changes that can occur with non-benzodiazepine hypnotics

Answer 24

decreased inhibitions
bizarre behaviors
sleep driving
hallucinations

Question 25

This is an α2 agonist non-benzodiazepine hypnotic which induces sleep, causing sedation without respirator depression

Answer 25

Dexmedetomidine

Question 26

What are two symptoms of dexmedetomidine

Answer 26

decreased blood pressure | bradycardia

Question 27

This is an slow onset anti-anxiety non-benzodiazepine hypnotic that is a partial serotonin agonist with no sedative or hypnotic effects

Answer 27

buspirone

Question 28

These barbiturates have a 3-4 hour duration

Answer 28

pentobarbital | secobarbital

Question 29

These barbiturates have a 6-8 hour duration

Answer 29

butaberbital | amobarbital

Question 30

These barbiturates have a 10-16 hour duration

Answer 30

phenobarbital

Question 31

what is the mechanism of action behind barbiturates

Answer 31

enhance the action of GABA; much more efficient that benzodiazepines

Question 32

barbiturates act on which who places

Answer 32

reticular activating system | acts on sensory cortex leading to unconsciousness

Question 33

are barbiturates more or less potent that benzodiazepines

Answer 33

less potent; use a higher dose

Question 34

True or False | barbiturates are not analgesics

Answer 34

True

Question 35

barbiturates act on this center; which if there is an OD of barbiturates it will lead to death due to respiratory depression

Answer 35

medullary respiratory center

Question 36

What other use besides hypnosis are barbiturates used for

Answer 36

epilepsy

Question 37

What are two contraindications of barbiturates

Answer 37

decreases respiration | TI = 10; used in suicides

Question 38

What can barbiturates interact with regarding other drugs

Answer 38

ethanol | synergistic CNS depression

Question 39

What can occur when someone who is dependent on barbiturates, stops taking them

Answer 39

they suppress REM sleep, so when you stop, you have a large increase in REM leading to nightmares

Question 40

These are melatonin receptor agonists; no effect of GABAergic pathways

Answer 40

rameltheon | tasimeltheon

Question 41

rameltheon and tasimeltheon help maintain what

Answer 41

normal circadian sleep rhythms; reduces the time to fall asleep

Question 42

What are two side effects of rameltheon and tasimeltheon

Answer 42

somnolence (sleepiness) | fatigue

Question 43

What are two long term symptoms of rameltheon and tasimeltheon

Answer 43

decreased testosterone synthesis | synergistic with ethanol

Question 44

What OTC can interact with rameltheon and tasimeltheon

Answer 44

anti-histamines; drowsiness