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Pharma Tbilisi > Sedatives & Hypnotics > Flashcards

Sedatives & Hypnotics Flashcards

(51 cards)

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1
Q

NE levels in anxiety and depression

A

Increased in anxiety
Decreased in depression

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2
Q

Dopamine levels in schizophrenia, Parkinson’s and depression

A

Increased in schizophrenia

Decreased in Parkinson’s

Decreased in depression

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3
Q

Serotonin levels in anxiety and depression

A

Decreased in anxiety

Decreased in depression

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4
Q

Classic triad of serotonin syndrome with examples

A

Mental status changes

Autonomic hyperactivity

Neuromuscular abnormalities

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5
Q

Treatment of serotonin syndrome

A

Cyproheptadine (serotonin antagonist)

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6
Q

ACh level in REM sleep, Alzheimers and Huntington’s disease

A

Increased in REM sleep

Decreased in Alzheimers

Decreased in Huntington’s disease

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7
Q

Major excitatory neurotransmitter

A

Glutamate

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8
Q

Receptor for glutamate

A

NMDA receptor

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9
Q

Phenycyclidine

A

Antagonist to NMDA receptor

Causes stimulatory side effects

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10
Q

What is a sedative?

A

AKA anxiolytics

Reduces anxiety and exerts a calming effect

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11
Q

What is a hypnotic?

A

Produces drowsiness

Encourage onset and maintenance of a state of sleep

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12
Q

Simpler examples in the sedative-hypnotic class?

A

Ethanol

Chloral hydrate

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13
Q

Something that differentiates benzodiazepines from barbiturates and alcohol?

A

Benzodiazepines will not progress past CNS depression into coma

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14
Q

Drugs that are GABAa agonists

A

Benzodiazepines

Barbiturates

Zolpidem, zaleplon, eszopiclon

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15
Q

Action of buspiron?

A

Serotonin receptor agonist

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16
Q

Action of Ramelteon

A

Melatonin agonist

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17
Q

Action of Suvorexant

A

Orexin antagonist that improves sleep duration

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18
Q

What is unique about buspirone’s anxiolytic effect?

A

It has a pure anxiolytic affect with no other effects

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19
Q

Clinical use of Buspirone

A

GAD

Begins to take effect after 1-2 weeks

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20
Q

GABA levels in anxiety and Huntington’s disease

A

Decreased in anxiety

Decreased in Huntington’s disease

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21
Q

GABA receptor anaesthetics

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A

Etomidate

Propofol

22
Q

Difference between mechanism of benzodiazepines and mechanism of barbiturates?

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A

Benzodiazepines potentiate GABA thereby increasing the frequency of Cl- channels opening

Barbiturates prolong GABA activity and thereby prolong the duration of Cl- channels opening

23
Q

What receptors do benzodiazepines and Barbiturates act on and where are they?

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A

Benzodiazepines bind to specific benzodiazepine binding sites that are part of the GABAa complex

Barbiturates bind to other binding sites on the GABAa complex

24
Q

How do the drugs with ‘z’ selectively cause sedation?

Study These Flashcards
A

They agonise Benzodiazepine-1 receptors but select against binding to benzodiazepine-2 receptors

25
How does buspirone eeduce anxiety without sedation?
Does not affect GABA Partial agonist at serotonin receptors
26
What is the antidote for sedative-hypnotic drugs?
Flumezanil
27
Which sedative-hypnotics can flumezanil not antagonise?
Barbiturates and alcohol as they bind to sites other than benzodiazepine receptors
28
Effects of sedation?
Decreases psychomotor and cognitive functions Disinhibition Anterograde amnesia
29
How does hypnosis affect sleep?
Sleep latency decreased Duration of stage 2 NREM sleep is increased (deep sleep) Duration of REM sleep is Decreased Duration of stage 3 NREM slow wave sleep is decreased
30
Barbiturates used for anaesthesia?
Thiopental Methohexital
31
Management of generalised convulsive status epilepticus?
IV lorazepam, diazepam or midazolam
32
Drug used in sedative-hypnotic withdrawal states
Diazepam Even in bezodiaepine withdrawal
33
What does orexin do and therefore what does suvorexant do?
Orexin causes wakefulness and therefore suvorexant enables sleep but antagonising orexin
34
Earliest features of alcohol withdrawal within hours to a day?
Mainly tremor
35
When do seizures, occur in alcohol withdrawal?
6 to 48 hours
36
When do hallucinations occur in alcohol withdrawal?
12 to 48 hours
37
When does delirium tremendous occur in alcohol withdrawal?
72 to 96 hours
38
What is delirium tremens?
Markedly altered mental status Autonomic hyperactivity
39
FDA approved drugs for alcoholism therapy?
Disulfiram Naltrexone Acamprosate
40
Why does naltrexone help alcoholics?
Endogenous opioids reinforce alcohol effects When given there is no buzz
41
How does acamprosate work for alcoholics?
Modulates NMDA receptors
42
What is Wernicke-Korsakoff syndrome?
Wernicke: acute encephalopathy Korsakoff: permanent neurological condition usually due to Wernicke
43
Causes of Wernicke-Korsakoff syndrome?
Thiamine (B1) deficiency Alcoholism
44
Brain finding in Wernicke-Korsakoff syndrome?
Atrophy of mammilary bodies
45
Features of Korsakoff syndrome?
Confabulation - can't remember so make things up Apathy Personality changes Amnesia, more likely anterograde
46
Features of foetal alcohol syndrome?
Growth restriction Midfacial hypoplasia Microcephaly Marked CNS dysfunction
47
Diagnosis of recurrent episodes of chest pain, tachycardia, SOB, sweating and tremulousness in a young, otherwise healthy patient?
Panic disorder
48
Best hypnotics for elderly patients?
Melatonin agonists like ramelteon
49
How are benzodiazepines administered in status epilepticus?
IV
50
What drugs should benzodiazepines not be used with?
Any drug that causes sedation
51
How do GABA agonists help in cerebral palsy?
Improve the spasticity that results from a decrease in descending inhibitory control

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