Sedatives and Hypnotics Flashcards Preview

Pharmacology > Sedatives and Hypnotics > Flashcards

Flashcards in Sedatives and Hypnotics Deck (28):
1

What do Benzodiazepines do to the EC50 for the GABA-induced Cl- influx

decreases it ie LEFT SHIFT (slide 18 of sedatives)

2

Actions of the benzodiazepines

1) reduction of anxiety
2) sedative and hypnotic actions
3) anticonvulsant
4) muscle relaxant
5) anesthesia

3

Name the short acting benzodiazepines please

Diazepam
Flurazepam

4

Name the intermediate acting benzodiazepines please

Alprazolam
Lorazepam
Temazepam

5

Name the long acting benzodiazepines please

Oxazepam
Triazolam

6

Name the benzodiazepines that are directly conjugated and are not metabolized at P450

oxazepam - short acting
lorazepam - intermediate acting
temezepam - intermediate acting
(TO < LAT < DF)

7

Which benzodiazepines are P450'd to intermediate active metabolites before being conjugated

diazepam
flurazepam
LONG ACTING

8

Treat me: I have skeletal muscle spasms from MS and cerebral palsy ie degenerative disorders

Dizepam - long acting

9

Treat me: seizures

clonazepam

10

Treat me: status epilepticus

diazepam - long acting
lorazeaom - intermediate

11

Treatm me: OH withdrawl

diazepma - long acting
oxazepam - short acting

12

Treat me: sleep disroders

flurazepma - long
temazepam - intermediate
triazolam - short

13

A/se of Benzoa

drowsy, confusion
ataxia
cognitive impairment
PARADOXICALs: anxiety, irritabiliyt, hostility, rage, paranoia, depression, suicidal ideation (dose related)

14

Withdrawal sxs of Benzos

confusion, anxiety, agitation, restlessness, insomnia, tension

15

MOA benzos

increase FREQUENCY of channel opening

16

MOA barbituates

increase DURATION of GABAa opening
inhibit glutamate receptors centrally
inhibit sodium receptors centrally

17

Actions of barbituates ie things to watch out for

respiratory depression - stops hypoxic chemoreceptor response to CO2
induceds p450s

18

Thiopental use

barbituate used IV to induce anesthesia - short duration

19

Phenobarbital use

barbituate long term management of a) tonic clonic seizures b) status epiliepticus and c) Eclampsia

20

N-phenylbarbital and phenobarbital use

kernicterus and hyperbilirubinemia

21

A/se of barbituates

(times five million)

CNS - drowsy, impaired concentrcation, mental and phys sluggy

paradoxical excitement

hypersensitivity

hang over

increased porphryin synthesis***

increases perception of pain***

dependence

poisoning - resp and CNS depression***

22

Differentiate between the three non-benzo benoz receptor agonists used for treatment of insomnia

ZOLPIDEM - short t 1/2, used if cxtzd by difficulty in sleep initiation (also ramelteon - 5HT1a agonist)
ZALEPLON - short t1/2 and rapid onset
ESZOPICLONE - longer 1/2; decreases sleep latency and improves sleep maintenance

23

What is Buspirone and who cares a bout it?

only anxiolytic (not hypnotic, not anticonvulsant or muscle relaxant)

used for ANXIETY
takes 2-3 weeks to work

5HT1 a receptor agonist

works like antidepressants

24

What is Ramelteon and who cares about it?

MT1 and MT2 melatonin receptor agonist

used @ insomnia with difficulty with sleep onset just like zolpidem (not zoleplon be careful zolpIdem with an i for insomnia)

25

Hydroxyzine as a sed/hyp

antihistamine with antiemetic activity
used for SYMPTOMATIC RELIEF OF ANXIERTY (kind of like clonidine)

26

Propanolol as a sed/hyp

Propanolol for Performance anxiety

27

Clonidine as a sed/hyp

modifiers autonomic expression of anxiety (kind of liek hydroxyzine)

28

Diphenhydramine and doxylamine

mild types of situational insomnia