1 Sedative-Hypnotic and Antianxiety Agents

Question 1

Drugs that are classified as sedative- hypnotic are used both to _________ and to __________.

Answer 1

relax the patient and to promote sleep.

Question 2

True or false: sedative-hypnotic and anti-anxiety agents are among the most commonly
used drugs worldwide.

Answer 2

True

Question 3

What are the two general categories for Sedative-Hypnotic Agents?

Answer 3

Benzodiazepines

Nonbenzodiazophines

Question 4

Which has more of a chance of a lethal dose, benzodiazepines or nonbenzodiazophines?

Answer 4

Nonbenzodiazophines have a small therapeutic index. 10x the therapeutic dose can be fatal

Question 5

True or false: benzodiazepines will have a residual effect the day after

Answer 5

True

Question 6

What is the mechanism of action for benzodiazepines as a sedative-hypnotic agent? What’s the over all effect?

Answer 6

Increases the inhibitory effects at the CNS synapses that use the neurotransmitter GABA

Decreases the level of arousal

Question 7

Which part of the brain do non benzodiazepines work on?

Answer 7

Midbrain

Question 8

In ambien a benzodiazepine or a nonbenzodiazophine?

Answer 8

Nonbenzodiazophine

Question 9

Which is newer: benzodiazepines or nonbenzodiazophines?

Answer 9

Nonbenzodiazophines

Question 10

What are the pharmacokinetics of benzodiazepines and nonbenzodiazophines?

Answer 10

• Lipid soluble
• Administered orally
• Absorbed completely from the gastrointestinal tract
• Distribution uniform throughout the body
• Hangover effect
• Excertion through the kidneys

Question 11

If a drug is lipid soluble, what does that imply in regards to the brain?

Answer 11

It can cross the blood brain barrier

Question 12

What are the side effects of sedative-hypnotic agents?

Answer 12

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

Question 13

What is tolerance?

Answer 13

the need to take more of a

drug to exert the same effects

Question 14

What is dependence?

Answer 14

described as the onset of

withdrawal symptoms if the drug is ceased

Question 15

What are the recommended precautions against sedative-hypnotic agents in regards to dependence?

Answer 15

• Withdrawal problems are associated with rebound insomnia
• Dosage must be tapered off
• Long term use of drugs should be avoided

Question 16

Besides hangover, dependence and tolerance, what are some other side effects associated with sedative hypnotic agents?

Answer 16

• GI discomfort with nausea and vomiting
• Dry mouth
• Sore throat
• Muscular incoordination • Cardiovascular and respiratory depression

NOT STARRED

Question 17

As a drug manufacturer, if a drug causes GI discomfort, what’s one way to address this?

Answer 17

Coat it

Question 18

What is anxiety?

Answer 18

Anxiety can be described as a fear or apprehension over a situation or event that an individual feels is threatening

Question 19

Why are antianxiety drugs taken?

Answer 19

• decrease tension and nervousness

- decrease anxiety

Question 20

What is the “front-line” drug given to treat anxiety?

Answer 20

Benzodiazepines

Question 21

What’s is the most frequently given benzodiazepine for anxiety?

Answer 21

Valium

Question 22

Benzodiazepines treat anxiety by causing _________ in spinal cord which causes ___________

Answer 22

Inhibition in spinal cord causes skeletal muscle relaxation

Question 23

True or false: Buspirone is a benzodiazepine

Answer 23

*not starred

False, it is an azapirone

Question 24

Which receptors does BuSpar work on to treat anxiety?

Answer 24

*not starred

Serotonin

Question 25

What are the benefits and disadvantages of using BuSpar to treat anxiety compared to benzodiazepines?

Answer 25

*not starred

• Less side effects
• Produces less sedation and
psychomotor impairement
• Decreased risk of tolerance

• Does not take effect quickly

Question 26

What are common side effects of sedative-hypnotic agents/ anti-anxiety drugs?

Answer 26

• Sedation is the most common side effect
• Psychomotor impairment ( driving)
• Addiction and abuse
• Withdrawal
• Rebound anxiety

Question 27

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

Prevalence of the use of these drugs in patient populations is _______

Answer 27

High

Question 28

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

Used extensively in _________ to
promote ________

Answer 28

Nursing homes to promote sleep

Question 29

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

Pt may be ______, more _______, and _____________

Answer 29

Calmer
Relaxed
Cooperative

Question 30

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

Drugs take full effect ___-___ hours after administration

Answer 30

2-4 hours

Question 31

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

If ___________ effects , participation in ___________ may be hazardous

Answer 31

If hypnotic effects, participation in physical activity may be hazardous

Question 32

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

Associated with _____ and _______

think about geriatric populations and sedative effects

Answer 32

Falls and fractures

Question 33

Special Considerations of Sedative- Hypnotic and Antianxiety Agents in Rehabilitation:

PTs must perform _______ training and _______ _________.

Answer 33

balance training, and

environmental modifications