Week 11 Benzos Flashcards
What meds are sedative hypnotics?
Benzos
Barbiturates
Alcohol
Newer sleeping meds (ambien)
Mechanism of action for sedative-hypnotics
Inhibit central nervous system
Sedatives- decrease activity, calm and modulate excitement
Hypnotics- produce drowsiness induce sleep
Major neurotransmitter in sedative hypnotics
GABA and cns inhibitors- chlorine ions open up channels
Is there a cross tolerance and cross dependence with all sedative hypnotics?
Yes
Difference between benzodiazepines
Rapid, duration, metabolites, half-life, potency, chemical structure
Barbiturates vs benzos
Benzos greater dosing difference
- less risk for tolerance and dependence
- less risk misuse potential
- higher therapeutic index
What aspects of the body can effect some benzos but not others?
Age and liver
Diazepam effected
Lorazepam not effected
What are the medicinal used for benzos
Anxiety- best used for acutely and short duration
Risk of benzos
Physical dependence/withdrawal and addiction
Symptoms of benzo withdrawal
Cognitive performance Psychomotor performance Impaired balance Depression/suicide Addiction
benzo withdrawal can have ____ and ____ symptoms
Prolonged and protracted
Short acting and long acting withdrawal
Short 24 7-21 days
Long 5-7 days
Glucuronide conjugation
Benzo metabolism
Rapid, metabolic, products inactive
Little change in half life as we age or with liver disease
Microsomal oxidation
Benzo metabolism
Slow, many metabolic products active
Significant change in half life as we age or with liver disease
Diazepam
Primary neuro transmitter in the brain
GABA
