Sedatives & Hypnotics & Anxiolytics Flashcards Preview

Pharmacology II > Sedatives & Hypnotics & Anxiolytics > Flashcards

Flashcards in Sedatives & Hypnotics & Anxiolytics Deck (25):
1

Decreasing dopamine has what effect?

promotes sleepiness

2

What sleep issue is MC for young adults?

difficulty falling asleep

3

What sleep issue is MC for middle-aged to elderly adults?

middle of the night waking

or

early morning awakening

4

In someone with short term sleep disorder, what is the first line therapy?

sleep hygiene and short acting Benzodiazepine receptor agonist

5

In someone with short term sleep disorder, what is the 2nd line treatment?

Trazodone

6

Sedative versus Hypnotic

Sedative - reduces anxiety and exerts calming effect

Hypnotic - produces drowsiness and encourages the onset and maintenance of sleep
-more pronounced CNS depression

7

What's the difference between barbituates and benzodiazepines?

Barbituates act like GABA. Can produce coma

Benzodiazepines improve action of GABA

8

MC Benzodiazepines used for insomnia

-Eszopiclone (Lunesta)
-Zaleplon (Sonata)
-Zolpidem (Ambien)

-->These are newer GABA agonists that only do sedation

9

Which hypnotics DO NOT form active metabolites

Oxazepam
Lorazepam (Ativan)
Zolpidem (Ambien)*


*=used most frequently

10

Most traditional Benzodiazepines have what downside

they maintain hypnotic effect for 1 month, THEN develop tolerance

11

What drug can reverse CNS depressant effects of benzodiazepines?

Flumazenil

12

Newer hypnotics

-Zolpidem (Ambien)
-Zaleplon (Sonata)
-Eszopiclone (Lunesta)


-->these are not benzos

13

Which barbiturate was previously used as "truth serum"

Amobarbital

14

Barbiturates: uses

1. Thiopental - anesthesia
2. Secobarbital - insomnia and sedation
3. Phenobarbital- seizure disorders

15

Between barbituates and benzos, which has a higher risk of dependence?

Barbiturates >benzodiazepines

16

Barbiturate Chloral hydrate (used in peds dentistry for sedation) can have what effect on bleeding?

-may displace coumarins and increase anticoagulant effects

17

Antihistamines used for sedation

-Diphenhydramine
-Doxylamine (Unisom)

18

Which antidepressant can cause daytime sedation and weight gain and is used in nursing homes for sun-downing?

Mirtazapine

19

Trazodone can be used for bedtime sedation to improve sleep continuity. What is a rare but serious side effect of this med?

Priaprism

20

Ramelteon

-melatonin-receptor agonist
-effective at treating sleep-onset difficulties in patients with COPD and sleep apnea

21

Valerian

-herbal remedy for sleep
-smells like old gym socks

22

Which -lam drugs are used for Anxiety

Alprazolam
Clonazepam

23

Which - lam drugs are used for sleep disorders??

Estazolam
Flurazepam
Triazolam
Zolpidem (Ambien)
Zaleplon
Eszopiclone

24

Buspirone

-anxiolytic
-minimal CNS depressant effects (can drive on this??)
-Slow onset >1 week
-active metabolite

25

Treatment of Panic Disorder

1. SSRIs
-Citalopram (Celexa) maximum dose is limited by QT prolongation**

2. SNRIs
3. Benzodiazepines
4. TCA
5. MAOI