1 Sedative-Hypnotic and Antianxiety Agents Flashcards
Drugs that are classified as sedative- hypnotic are used both to _________ and to __________.
relax the patient and to promote sleep.
True or false: sedative-hypnotic and anti-anxiety agents are among the most commonly
used drugs worldwide.
True
What are the two general categories for Sedative-Hypnotic Agents?
Benzodiazepines
Nonbenzodiazophines
Which has more of a chance of a lethal dose, benzodiazepines or nonbenzodiazophines?
Nonbenzodiazophines have a small therapeutic index. 10x the therapeutic dose can be fatal
True or false: benzodiazepines will have a residual effect the day after
True
What is the mechanism of action for benzodiazepines as a sedative-hypnotic agent? What’s the over all effect?
Increases the inhibitory effects at the CNS synapses that use the neurotransmitter GABA
Decreases the level of arousal
Which part of the brain do non benzodiazepines work on?
Midbrain
In ambien a benzodiazepine or a nonbenzodiazophine?
Nonbenzodiazophine
Which is newer: benzodiazepines or nonbenzodiazophines?
Nonbenzodiazophines
What are the pharmacokinetics of benzodiazepines and nonbenzodiazophines?
- Lipid soluble
- Administered orally
- Absorbed completely from the gastrointestinal tract
- Distribution uniform throughout the body
- Hangover effect
- Excertion through the kidneys
If a drug is lipid soluble, what does that imply in regards to the brain?
It can cross the blood brain barrier
What are the side effects of sedative-hypnotic agents?
RESIDUAL EFFECTS
• Drowsiness and decreased motor performance the next day
• Caused by redistribution of CNS
from peripheral storage sites, or
drug has not been fully metabolized
• Anterograde amnesia esp in elderly
• give smaller dose using a drug with
a shorter half life
What is tolerance?
the need to take more of a
drug to exert the same effects
What is dependence?
described as the onset of
withdrawal symptoms if the drug is ceased
What are the recommended precautions against sedative-hypnotic agents in regards to dependence?
- Withdrawal problems are associated with rebound insomnia
- Dosage must be tapered off
- Long term use of drugs should be avoided
Besides hangover, dependence and tolerance, what are some other side effects associated with sedative hypnotic agents?
- GI discomfort with nausea and vomiting
- Dry mouth
- Sore throat
- Muscular incoordination • Cardiovascular and respiratory depression
NOT STARRED
As a drug manufacturer, if a drug causes GI discomfort, what’s one way to address this?
Coat it
What is anxiety?
Anxiety can be described as a fear or apprehension over a situation or event that an individual feels is threatening
Why are antianxiety drugs taken?
- decrease tension and nervousness
- decrease anxiety
What is the “front-line” drug given to treat anxiety?
Benzodiazepines
What’s is the most frequently given benzodiazepine for anxiety?
Valium
Benzodiazepines treat anxiety by causing _________ in spinal cord which causes ___________
Inhibition in spinal cord causes skeletal muscle relaxation
True or false: Buspirone is a benzodiazepine
*not starred
False, it is an azapirone
Which receptors does BuSpar work on to treat anxiety?
*not starred
Serotonin
What are the benefits and disadvantages of using BuSpar to treat anxiety compared to benzodiazepines?
*not starred
• Less side effects
• Produces less sedation and
psychomotor impairement
• Decreased risk of tolerance
• Does not take effect quickly
What are common side effects of sedative-hypnotic agents/ anti-anxiety drugs?
- Sedation is the most common side effect
- Psychomotor impairment ( driving)
- Addiction and abuse
- Withdrawal
- Rebound anxiety
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
Prevalence of the use of these drugs in patient populations is _______
High
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
Used extensively in _________ to
promote ________
Nursing homes to promote sleep
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
Pt may be ______, more _______, and _____________
Calmer
Relaxed
Cooperative
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
Drugs take full effect ___-___ hours after administration
2-4 hours
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
If ___________ effects , participation in ___________ may be hazardous
If hypnotic effects, participation in physical activity may be hazardous
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
Associated with _____ and _______
think about geriatric populations and sedative effects
Falls and fractures
Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:
PTs must perform _______ training and _______ _________.
balance training, and
environmental modifications
