08_Sedative-Hypnotics, Benzos, and Beta Blockers

Question 1

Sedative-Hypnotics:

Three Classes

Answer 1

Barbiturates

Anxiolytics

Alcohol

Question 2

Sedative-Hypnotics:

Overview

Answer 2

Generalized CNS depressants

Effects are dose-dependent

Question 3

Sedative-Hypnotics:

Low doses

Answer 3

Reduce arousal and motor activity

Question 4

Sedative-Hypnotics:

Moderate doses

Answer 4

Induce sedation and sleep

Question 5

Sedative-Hypnotics:

High Doses

Answer 5

Anesthesia

Coma

Death

Question 6

Sedative-Hypnotics:

Subjective experience

Answer 6

Initial increase in activity and feelings of elation
*suppression of inhibitory mechanisms

Sedating and hypnotic effects
*supppression of excitatory mechanisms

Question 7

Sedative-Hypnotics:

Cross-tolerance

Answer 7

When tolerance develops to one sedative-hypnotic, is likely to be shown for others as well

Question 8

Barbiturates:

Four Main Examples

Answer 8

Phenobarbital

Amobarbital

Pentobarbital

Secobarbital

Question 9

Barbiturates:

Uses

Answer 9

Sedatives and anesthetic agents

Infrequently prescribed present-day

Question 10

Barbiturates:

Mechanism of action

Answer 10

Interrupts impulses to the reticular activating system

Question 11

Barbiturates:

Side effects

Answer 11

Slurred speech

Nystagmus

Dizziness

Irritability

Impaired motor and cognitive performance

Question 12

Barbiturates:

Overdose Symptoms

Answer 12

Ataxia

Confusion

Agitation

Respiratory depression

Death

Question 13

Barbiturates:

Dangers

Answer 13

Tolerance occurs but respiratory system does not adapt

Increased dose to maintain soporific effects can be lethal

High abuse potential

Frequently involved in suicides and accidental deaths

Question 14

Benzodiazepines:

Overview

Answer 14

Most commonly prescribed anxiolytic

*Anxiolytics are the most widely used psychiatric medication

Question 15

Benzodiazepines:

Seven Main Examples

Answer 15

Diazepam (Valium)

Alprazolam (Xanax)

Lorazepam (Ativan)

Clonazepam (Klonopin)

Triazolam (Halcion)

Chlordiazepoxide (Librium)

Oxazepam (Serax)

Question 16

Benzodiazepines:

Uses

Answer 16

Relieve anxiety (Primary Use)

Seizures

Sleep disturbance

Cerebral palsy

Alcohol withdrawal

Question 17

Benzodiazepines:

Mechanism of action

Answer 17

Stimulate inhibitory action of GABA

Question 18

Benzodiazepines:

Side effects

Answer 18

Drowsiness, Dizziness Lethargy

Ataxia

*Side effects alleviated by lowering the dosage

Question 19

Benzodiazepines:

Less common side effects

Answer 19

Paradoxical excitation/agitation

Irritability, hostility

Question 20

Benzodiazepines:

Abrupt withdrawal symptoms

Answer 20

Rebound hyperexcitability

Seizures

Depersonalization

Panic

Stroke

Question 21

Anxiolytics:

Azapirone (buspirone)

Answer 21

Reduces anxiety without sedation

Nonaddictive

Non-habit-forming

Not subject to abuse

*Therapeutic effects require several weeks

Question 22

Beta-Blockers:

Overview and Main example

Answer 22

Reduce physical symptoms associated with anxiety

Propranolol (Inderal)

Question 23

Beta-Blockers:

Uses

Answer 23

High blood pressure

Angina

Tremors

Migraine

Glaucoma

Question 24

Beta-Blockers:

Propanolol (Inderal) Side effects

Answer 24

Bradycardia

Shortness of breath

Arterial insufficiency (e.g. Raynaud’s)

Nausea

Diarrhea

Depression

Dizziness

Sexual dysfunction

Question 25

Beta-Blockers:

Abrupt Discontinuation Symptoms

Answer 25

Sweating

Palpitations

Headache

Tremulousness

Cardiac arrhythmia

Question 26

Propranolol (Inderal):

Contraindication

Answer 26

Obstructive pulmonary disease

Respiratory problems