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Pharmacology > Sedatives, Anxiolytics, Anticonvulsant > Flashcards

Sedatives, Anxiolytics, Anticonvulsant Flashcards

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0
Q

Drugs that produce drowsiness and encourage the onset and maintenance of a state of sleep. Involve more pronounced CNS depression than sedation

A

Hypnotics

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1
Q

Drugs that reduce anxiety and exert calming effect

A

Sedatives (anxiolytics)

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2
Q

Major inhibitory neurotransmitter?

A

GABA - Glycine in the spinal cord

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3
Q

Major excitatory neurotransmitters?

A

Glutamate, aspartate (dicarboxylate)

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4
Q

Short acting benzodiazepine, for acute anxiety, anesthesia induction, preoperative sedation. May cause anterograde amnesia. And has additive CNS depression with ethanol

A

Midazolam

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5
Q

Intermediate acting benzodiazepine, for anxiety disorders, insomnia, tranquilizer. With additive CNS depression with ethanol

A

Lorazepam

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6
Q

What abnormal sleep pattern results from use of benzodiazepines?

A

Decreased REM sleep

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7
Q

Long acting benzodiazepine, for anxiety disorder, skeletal muscle relaxation, alcohol withdrawal. May cause anterograde amnesia.

A

Diazepam - binds GABA A receptor subunits to increase frequency of chloride channel opening. Membrane hyperpolarization

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8
Q

Benzodiazepine drug used as a date-rape drug.

A

Flunitrazepam together with Alcohol (most common) and Gamma hydroxybutyrate

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9
Q

Which benzodiazepine has the longest half life?

A

Chlordiazepoxide

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10
Q

Preferred benzodiazepine: anticonvulsant maintenance

A

Clonazepam - intermediate

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11
Q

Preferred benzodiazepine: status epilepticus

A

Lorazepam and diazepam

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12
Q

Preferred benzodiazepine: skeletal muscle relaxation

A

Diazepam - eg. Cerebral palsy

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13
Q

Preferred benzodiazepine: panic disorders and phobias

A

Alprazolam, Clonazepam

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14
Q

Preferred benzodiazepine: insomnia

A

Estrazolam, Flurazepam and Triazolam

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15
Q

Preferred benzodiazepine: anesthesia induction

A

Midazolam and Diazepam

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16
Q

Preferred benzodiazepine: bipolar disorder

A

Clonazepam

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17
Q

Preferred benzodiazepine: alcohol withdrawal

A

Chlordiazepoxide and Diazepam

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18
Q

Antidote for Benzodiazepine toxicity

A

Flumazenil - a competitive BZ receptor antagonist

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19
Q

Ultrashort acting barbiturate, for anesthesia induction and increased ICP. May cause acute intermittent porphyria

A

Thiopental-potent inducer of CYP450 enzymes

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20
Q

Short to intermediate acting barbiturate for insomnia, preoperative sedation

A

Pentobarbital

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21
Q

Long acting barbiturates, for insomnia. Gilbert disease, seizure disorder in children

A

Phenobarbital - bind to GABA A receptor sites. Increases duration of chloride channel opening

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22
Q

Imidazopyridine drug, for insomnia only. Lacks anti-convulsant, anti-anxiety and muscle relaxant

A

Zolpidem - SIMD: Zaleplon and Eszopiclone

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23
Q

Anxiolytic drug for generalized anxiety disorder by partial agonist at 5-HT receptors and possibly D2 receptors

A

Buspirone - no anticonvulsant, no muscle relaxant properties with minimal CNS depressant effects

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24
Effects of Zolpide. Can be reversed with?
Flumazenil
25
Cytosolic, NAD+ dependent enzyme, mainly in liver and gut, for metabolism of low to moderate doses of ethanol
Alcohol dehydrogenase | Fixed metabolism of ethanol:7-10g/h
26
Responsible for ethanol metabolism at blood levels higher than 100mg/dL
Microsomal Ethanol Oxidizing System (MEOS)
27
Blood alcohol concentration that causes impairment of driving ability
60-80mg/dL
28
Blood alcohol concentration that causes coma
300 to 400mg/dL
29
Blood alcohol concentration that causes respiratory depression and death
>500mg/dL
30
Most common neurologic abnormality in chronic alcoholics
Peripheral neuropathy
31
Syndrome associated with alcohol use presenting with ataxia, confusion, paralysis of the extra-ocular muscles
Wernicke-Korsakoff syndrome
32
Changes in the brain seen in Wernicke-Korsakoff syndrome.
Hemorrhagic necrosis of the mamillary bodies
33
Most common mental retardation syndrome, presents with microcephaly, underdevelopment of midface region associated with heavy consumption of alcohol during the first trimester of pregnancy
Fetal alcohol syndrome
34
Drug of choice for alcohol withdrawal syndrome
Long acting benzodiazepines
35
Inhibits aldehyde dehydrogenase leading to acetaldehyde accumulation then nausea, headache, flushing and hypotension
Disulfiram
36
What Drugs can causes Disulfiram reaction?
``` Chlorpropamide Cefoperazone Cefomandole Cefotetan Procarbazine Metronidazole ```
37
Treatment for methanol poisoning
Ethanol - retards formation of formaldehyde | Fomepizole - inhibitor of alcohol dehydrogenase
38
Refers to finite episode of brain dysfunction resulting from abnormal discharge of cerebral neurons
Seizures
39
Type of seizure wherein the consciousness is preserved
Simple partial seizures
40
Type of seizure: impaired consciousness
Complex partial seizure
41
Type of seizure: involves abrupt loss of consciousness, muscle rigidity and respiratory arrest for less than 1min then followed with jerking of the body muscles, lip and tongue biting, and fecal and urinary incontinence for 2-3mins
Generalized tonic-clonic seizure (Grand Mal)
42
Type of seizure: with impaired consciousness (often abrupt onset and brief) begin in childhood and usually cease by age of 20years
Absence seizure (Petit Mal)
43
Type of seizure: sudden, brief, shocklike contractions of musculature (myoclonic jerks)
Myoclonic seizures
44
Series of seizures (usually tonic-clonic) without recovery of consciousness between attacks. Life-threatening emergency
Status epilepticus
45
Anticonvulsant drug for generalized tonic-clonic seizure, partial seizures. Status epilepticus. May cause ataxic diplopia, gingival hyperplasia. Follows zero order kinetic, potent inducer of CYP450
Phenytoin - blocks voltage-gated Na channels
46
Drug of choice for Trigeminal neuralgia
Carbamazepine
48
Anticonvulsant drug for generalized tonic-clonic seizures, partial seizures, bipolar disorder and trigeminal neuralgia
Carbamazepine - blocks voltage gated Na channels and decreases glutamate release
49
Anticonvulsant drug for myoclonic seizure, generalized tonic-clonic seizures and acute mania. May cause Spina bifida. Inhibitor of CYP450
Valproic acid - blocks high-frequency firing of neurons modifies amino acid metabolism
50
Anticonvulsant drug for absence seizures. May cause GI distress, lethargy, headache and behavioral changes
Ethosuximide - decreases Ca2+ currents in thalamus
51
Anticonvulsant drug for partial seizure, neuropathic pain and migraine. May cause dizziness, sedation, nystagmus, tremor and ataxia
Gabapentin - SIMD: Pregabalin, blocks Ca2+ channels, increases GABA release. Inhibits neuronal discharge from seizure foci
52
Anticonvulsant drug for generalized tonic-clonic seizure, partial seizures and juvenile myoclonic epilepsy
Levetiracetam - selectively binds synaptic vesicular protein SV2A. Modify synaptic release of glutamate and GABA
53
Anticonvulsant drug for generalized tonic-clonic seizures, absence seizures, partial seizures, Lennox-Gastaut syndrome, West syndrome and migraine. Noted to be the anti-seizure drug with most number of mechanisms of action
Topiramate - multiple actions on synaptic function via actions on phosphorylation
54
Drugs of choice: generalized tonic-clonic seizures
Valproic acid Phenytoin Carbamazepine
55
Drugs of choice: partial seizure
Carbamazepine Lamotrigine Phenytoin
56
Drugs of choice: absence mal
Ethosuximide | Valproic acid
57
Drugs of choice: myoclonic and atypical absence syndromes
Valproic acid
58
Drugs of choice: status epilepticus
Lorazepam Diazepam Phenytoin Phenobarbital
59
First line for patients with mania, bipolar affective disorder
Valproic acid
60
Drug of choice for Trigeminal neuralgia
Carbamazepine

Pharmacology (11 decks)

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