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Sedative-hypnotics Flashcards

(43 cards)

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1
Q

what is a short acting benzo

A

triazolam

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2
Q

what is a intermediate acting benzo

A

alprazolam

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3
Q

what is a long acting benzo

A

flurazepam

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4
Q

what is a ultra-short acting barbiturates

A

thiopental

–used for anesthesia

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5
Q

what is a short acting barbiturates

A

secobarbital

–used for insomnia

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6
Q

what is a long acting barbiturates

A

phenobarbital

–used seizures

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7
Q

list of misc agents

A

buspirone
eszopiclone
zaleplon
zolpidem

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8
Q

list of benzos

A 
alprazolam
chlordiazepoxide
clonazepam
clorazepam
diazepam
flurazepam
lorazepam
midazolam
oxazepam
triazolam
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9
Q

list of barbiturates

A

-barbital

thiopental

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10
Q

what is flumazenil

A

benzo antagonist

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11
Q

definition of a sedative

A

drugs that decreases CNS activity, moderates excitement, and calms the recipient

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12
Q

definition of hypnotic

A

drugs that produce drowsiness and facilitates the onset & maintenance of sleep & from which the recipient can be aroused easily

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13
Q

MOA of benzos

A

act on GABAa receptors

  • -increase Cl influx, cause hyperpolarization, decreased # of action potentials
  • -cause sedation, hypnotic effects, muscle relaxation, anxiolytic & anticonvulsant effects
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14
Q

MOA of barbiturates

A

act on GABAa receptors

  • -cause wide spectrum of effects: mild sedation to anesthesia
  • -increase chloride influx, causes hyperpolarization, decreased # of action potentials
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15
Q

MOA of misc sedative-hypnotics

A

act on multiple receptors: GABAa, melatonin

–used as sleep aids, tx of delirium, anxiety, seizures

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16
Q

advantages & disadvantages of using benzos for anxiety

A

advantages: high therapeutic index, antagonist available (flumazenil), low risk drug interactions, minimal CV effect
disadvantages: risk of dependence, CNS depression, amnestic effects

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17
Q

dIazepam

A

1/2 life: >100 hrs
active metabolites: yes
pathway of metabolism: oxidation
rate of onset via oral: very fast

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18
Q

alprazolam

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A

1/2 life: 12-15 hrs
active metabolites: not important
pathway of metabolism: oxidation
rate of onset via oral: fast

19
Q

cumulative toxicity

Study These Flashcards
A

benzos with long 1/2 lives are more likely to cause cumulative effects (excessive drowsiness) with multiple doses

20
Q

indications for alprazolam

Study These Flashcards
A

management of anxiety disorder, or short-term relief of symptoms
also tx of panic disorder

warnings: dependence & withdrawal rxs including seizures

21
Q

midazolam drug profile

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A
  • -given IM or IV
  • -IV for sedation/anxiolysis/amnesia prior to procedures
  • -warnings: assoc with resp depression & arrest
22
Q

diazepam drug profile

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A
  • -exerts anxiolytic, sedative, muscle relaxant, anticonvulsant
  • -has distribution phase (1/2 life 48 hours) followed by terminal elimination phase (1/2 life up to 100 hrs)
  • -1/2 life increased in mild-mod cirrhosis
  • -management of anxiety disorders
  • -can be used for acute alcohol withdrawal to relieve agitation & tremor
  • -contraindicated in myasthenia gravis, sleep apnea,
  • -WARNING: not recommended for tx of psychotic pts
23
Q

When is oxazapam used

Study These Flashcards
A

tx of anxiety, anxiety with depression, and acute alcohol withdrawal

24
Q

when is triazolam used

Study These Flashcards
A

short term tx of insomnia (7-10 days)

BB warning: if used with opioids may result in sedation, resp depression, coma, and death

25
when is chlordiazepoxide used
management of anxiety disorders or for short term relief of symptoms. acute alcohol withdrawal, preoperative apprehension BB warning:if used with opioids may result in sedation, resp depression, coma, and death
26
when is flurazepam used
long acting hypnotic used for tx of insomnia
27
when is lorazepam used
tx of seizure disorders | can be used before surgery for anxiety
28
flumazenil
- -benzo receptor antagonist - -complete or partial reversal of sedative effects of benzos when general anesthesia has been induced or in management of benzo overdose - -warning: has been assoc with occurence of seizures
29
what are barbiturates
tx of anxiety, epilepsy, to induce sleep, and as anesthetics - -extreme cases of insomnia - -seizures that are unresponsive to other, less toxic, agents - -induction of anesthesia - -in combo with acetaminophen & caffeine for tension HA - -counteract the stimulant effects from drugs such as cocaine & meth
30
thiopental drug profile
administered by IV as the sole anesthetic agent for brief 15 min procedures for control of convulsive states during or following inhalation anesthesia, local anesthesia, or other causes AE: --resp depression, myocardial depression, cardiac arrhythmias, prolonged somnolence
31
secobarbital drug profile
Indications: - -hypnotic, short-term tx of insomnia- loses effectiveness after 2 wks - -preanesthestic
32
phenobarbital drug profile
Indications: - -used as a sedative or hypnotic - -contraindicated in those with history of porphyria - -administered with caution in those who are mentally depressed, have suicidal tendencies, or a hx of drug abuse
33
benzos can be used for insomnia but cause what?
daytime sedation & pts may develop anterograde amnesia & tolerance
34
What drugs are used for insomnia?
zolpidem, zaleplon, and eszopiclone
35
MOA of newer hypnotics
binds to GABAa receptors that contain a1 subunit - -increase chloride influx, increase hyperpolarization, decrease # of action potentials - -only approved for sleep disorders - -no anxiolytic, anesthetic, anticonvulsant, muscle relaxing, resp or cv effects DRUGS: eszopiclone, zolpidem, zaleplon
36
Buspirone drug profile
- -approved for tx of generalized anxiety disorder | - -anxiolytic effects may take more than 1 wk to become established
37
zaleplon drug profile
- -short term tx of insomnia | - -contraindicated in pt with hypersensitivity to drug
38
zolpidem drug profile
- -indicated for short term tx of insomnia characterized by difficulties initiating sleep - -warnings: severe anaphylactic reactions, worsening of depression - -drug interactions: CNS depressants
39
ramelteon drug profile
- -indicated for tx of insomnia characterized by difficulty with sleep onset - -melatonin receptor agonist
40
eszopiclone drug profile
- -indicated for tx of insomnia-- decrease sleep latency & improve sleep maintenance - -warnings: CNS depressant effects - -SE: unpleasant taste, somnolence, resp infection, HA
41
meprobamate drug profile
- -indicated for tx of anxiety disorders or for short-term relief of symptoms of anxiety - -works by slowing activity in the brain to allow for relaxation
42
chloral hydrate drug profile
--short term use as a sedative or sleep medicine
43
The failure of insomnia to remit after how many days of tx may indicate the presence of a primary psychiatric &/or medical illness that should be evaluated?
7-10 days

Psych (8 decks)

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