Pharmacology of Sedation Drugs Flashcards Preview

Human Diseases > Pharmacology of Sedation Drugs > Flashcards

Flashcards in Pharmacology of Sedation Drugs Deck (24)
Loading flashcards...
1
Q

Define conscious sedation

A

Reduction or abolition of physiological and psychological responses to the stress of dentistry, without loss of consciousness, cooperation or protective reflexes

2
Q

List 3 routes of drug administration?

A

Intravenous
Inhalation
Oral

3
Q

Advantages of IV administration?

A

Certain absorption

4
Q

Advantages of inhalation administration?

A

Rapid absorption and onset fo sedation, rapid elimination and recovery

5
Q

Disadvantages of oral route of administration?

A

Slow onset, gastric absorption

6
Q

Describe benzodiazepines mode of action?

A

Act on receptors in CNS to enhance effect of GABA

7
Q

What is the effect of GABA?

A

Inhibit neurotransmission

8
Q

Where are GABA receptors located?

A

Cerebral cortex and motor circuits

9
Q

Where are benzodiazepine receptors located?

A

Also to GABA receptors

10
Q

Clinical effects of benzodiazepines?

A
Anxiolysis (reduced fear)
Sedation
Detachment
Amnesia
Muscle relaxation 
Disinhibitiion (more agitated, violent - more common in teenagers)
Anti-convulsion
11
Q

Benzodiazepines effect on pain?

A

They are not analgesics - may influence the pain response (psychologically)

12
Q

Midazolam is water soluble at pH<4 and lipid solute at physiological pH, why is this important?

A

Allows penetration of blood-brain barrier

13
Q

Why is midazlolam chosen over diazepam?

A

2-3 times more potent

14
Q

Why are elderly more sensitive to midazlolam?

A

Decreased protein binding

15
Q

Where is midazlolam metabolised?

A

Liver

16
Q

Where is midazlolam excreted?

A

Kidney

17
Q

What are the side-effects of benzodiazepines?

A

Respiratory depression
Cardiovascular effect - reduced BP
Drug interactions

18
Q

How do benzodiazepines cause respiratory depression?

A

CNS depression and muscle relaxation, causing decreased cerebral response to CO2

19
Q

How do benzodiazepine effect cardiovascular system?

A

Reduced BP by decrease in vascular resistance, increased HR due to baroreceptor response
Cardiac output unaffected

20
Q

What kind of drug interactions re important with BZP?

A

Synergistic CNS depression with other CNS depressants e.g. opiates, alcohol
Erythromycin and cimetidine inhibit metabolism

21
Q

Clinical use of nitrous oxide?

A

Inhalation sedation

22
Q

Describe nitrous oxide gas?

A

Colourless, with sweet odour

23
Q

Clinical effects of nitrous oxide?

a) sedation
b) cardiovascular
c) respiratory system

A

a) Depressive and euphoriant effects
Depressed sensation: touch, pain, hearing, vision
b) minimal, myocardial depressant at high dose
c) mild depression of alveolar ventilation and co2 response

24
Q

List side-effects of nitrous oxide

A

Hazards to professional with chronic exposure
Haematological problems - oxidises B12
causing pernicious anaemia
Neurological disease and hepatic disease with chronic exposure
Decreased fertility