Sedative-Hypnotics and Alcohol Flashcards

1
Q

Anxiety is usually ___ to other disorders

A

Anxiety is usually secondary to other disorders

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2
Q

What is anxiety?

A

Feelings of fear, tension, apprehension, etc.

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3
Q

The best way to treat anxiety is often to…

A

Treat the underlying illness

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4
Q

What are sedative-hypnotics?

A

Benzodiazepines and barbiturates.

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5
Q

What are anxiolytic drugs?

A

Sedative drugs that help treat anxiety without impacting motor or mental function

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6
Q

What are hypnotics?

A

Drugs that produce drowsiness and induce sleep

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7
Q

What are benzodiazepines?

A

Drugs that bind to a separate site on GABAa receptors and increase the frequency of Cl-channel openings.

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8
Q

No matter how high the dose, benzodiazepines require ____ for their effects.

A

They only work in the presence of GABA

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9
Q

Give an example of a benzodiazepine

A

Diazepam (VALIUM)

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10
Q

How is diazepam broken down?

A

Phase I: Diazepam is oxidized by cytochrome P450

Its metabolites are active (they produce the same calming effects)

Phase II: Interaction with glucuronide makes it passable in urine

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11
Q

What is an example of a barbiturate?

A

Phenobarbital

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12
Q

What makes barbiturates different from benzodiazepines like Diazepam?

A

They have a smaller safety margin

Their metabolites are generally not active

At high doses, barbituates can directly activate GABAa receptors

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13
Q

Barbiturates can increase the expression of some cytochrome p450 enzymes which is…

A

dangerous because cytochrome p450 plays a big role in drug metabolism, it messes with the breakdown rates of other drugs.

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14
Q

Both benzodiazepines and barbiturates enhance Cl- conductance which…

A

Increases the inhibition of many neurons all throughout the brain

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15
Q

Benzodiazepines and barbiturates bind to ____ sites on GABAa receptors

A

different sites, meaning their effects can stack

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16
Q

Sedative hypnotics are used to treat…

A

Anxiety, insomnia, psychosis, epilepsy, alcohol withdrawl

17
Q

Before surgery, sedative-hypnotics are given as part of the

A

anesthesia process

18
Q

What are some of the adverse effects of sedative-hypnotics (benzos and barbiturates)

A

Dose-dependent CNS depression (ranging from impaired motor skills -> coma -> death) *CNS depression can combine with other drugs ex. alcohol

Withdrawal symptoms after prolonged use

Tolerance will develop

Extra toxic if liver function is impaired

19
Q

How does THC regulate anxiety?

A

the endocannabinoid system regulates anxiety by dampening excitatory glutamate signals (THC decreases glutamate release)

20
Q

How does marijuana become addictive?

A

Chronic marijuana use down-regulates receptors, leading to increased anxiety due to a lack of receptors available for the natural endocannabinoid system

21
Q

Endocannabinoids work by ____ by activating CB1 receptors

A

inhibiting transmitter release by activating CB1 receptors

22
Q

Marijuana contains compounds which…

A

activate CB1 receptors

23
Q

Overall THC is responsible for reducing the release of both ____

A

Glutamate and GABA

24
Q

What is ethanol?

A

Beer, wine, rum etc

25
What are the acute effects of ethanol?
DOSE DEPENDANT CNS depression Decreased membrane excitability Increased GABAa activation Decreased NMDA activation
26
How does ethanol impact myocardial contractility?
Initially, it is increased, then it decreases.
27
What are the behavioral effects of ethanol?
Decreased anxiety, impaired judgement, slurred speech
28
What happens when a toxic dose of ethanol is taken?
CNS and respiratory depression
29
What are the chronic effects of ethanol use?
liver failure pancreatitis and gastritis malnutrition
30
How is 90% of ethanol metabolized?
In the liver Major pathway: alcohol dehydrogenase Minor pathway: cytochrome p450
31
How is the last 10% of ethanol metabolized?
Its excreted in the lungs and urine
32
Alcohol has a ___ clearance rate
constant clearance rate
33
How is ethanol different from methanol?
Methanol has the same CNS depression effects When metabolized, methanol turns into formic acid -> builds up in retina -> blindness
34
How do you treat methanol poisoning?
With ethanol Ethanol has a higher affinity for alcohol dehydrogenase so the formic acid levels won't peak as high