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PHARMA > 1B CNS : Hypnotics and Sedatives > Flashcards

1B CNS : Hypnotics and Sedatives Flashcards

1
Q
  1. fear response due to an appropriate stimulus
  2. the fear response is executed in the body by an extensive increase in what neurotransmitter release
A

anxiety

noradrenalin

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2
Q

the fear response consists of 2 components

CENTRAL COMPONENT - what location?

PERIPHERAL COMPONENT - what system is involved?

A

Central- locus ceruleus of the CNS

Peripheral- the sympathetic nervous system

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3
Q

a pathological fear response due to an inappropriate stimulus

A

anxiety disorder

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4
Q

a pathological fear response due to an inappropriate stimulus

A

anxiety disorder

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5
Q

there are 3 main types of anxiety disorders

A
  1. Generalized Anxiety Disorder
  2. Panic Disorder
  3. Phobia
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6
Q

MATCHING TYPE:
A. Generalized Anxiety Disorder
B. Panic Disorder
C. Phobia

  1. extensive repeating attacks of fear response
  2. chronic fear response without any definite stimulus
  3. fear response
A

GENERALIZED ANXIETY DISORDER - **chronic fear **response without any definite stimulus

PANIC DISORDER - extensive repeating attacks of fear response

PHOBIA - fear response

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7
Q

A drug that subdues excitement and calms the subject without inducing sleep, though drowsiness may be produced.

A

Sedative

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8
Q

refers to decreased responsiveness to any level of stimulation; is associated with some decrease in motor activity and ideation

A

Sedation

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9
Q

A drug that induces and/or maintains sleep, similar to normal arousable sleep.

A

Hypnotic

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10
Q

HYPNOTICS OR SEDATIVES?

quicker onset, shorter duration and steeper dose-response curves

A

hypnotics

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10
Q

HYPNOTICS OR SEDATIVES?

quicker onset, shorter duration and steeper dose-response curves

A

hypnotics

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11
Q

HYPNOTICS OR SEDATIVES?

**more slowly **acting drugs with **flatter dose-response **curves

A

sedatives

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12
Q

SLEEP STAGES

  • EEG shows θ, δ and spindle activity,
  • K complexes can be evoked with** strong stimuli only. **
    * Eye movements are few; subjects are not easily arousable
    Comprises 5–8% of sleep time.
A

Stage 3

(deep sleep transition)

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13
Q

SLEEP STAGES

  • From** lying down to falling asleep** and occasional nocturnal awakenings;
  • constitutes **1–2% **of sleep time.
  • EEG shows** α activity when eyes are closed** and **β activity when eyes are open. **
  • Eye movements are irregular or slowly rolling.
A

Stage 0
(awake)

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14
Q

SLEEP STAGES

  • α activity is interspersed with θ waves.
  • Eye movements are reduced but there may be **bursts of rolling. **
  • **Neck muscles relax. **
  • Occupies 3–6% of sleep time
A

Stage 1
(dozing)

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15
Q

SLEEP STAGES

  • * θ waves with interspersed spindles,
  • K complexes can be evoked on sensory stimulation;
  • * little eye movement;
  • subjects are easily arousable
  • This comprises **40–50% **of sleep time.
A

Stage 2

(unequivocal sleep)

16
Q

SLEEP STAGE

  • δ activity predominates in EEG,
  • K complexes** cannot be evoked. **
  • Eyes are practically fixed; subjects are difficult to arouse.
  • Night terror may occur at this time.
  • It comprises 10–20% of sleep time.
A

Stage 4

(cerebral sleep)

17
Q

TRUE OR FALSE

  1. During stage 2, 3 and 4 heart rate, BP and respiration are steady and **muscles are relaxed. **
  2. Stages 3 and 4 together are called slow wave sleep (SWS).
A
18
Q

Characteristics of REM sleep / paradoxical sleep

A
  1. EEG has waves of all frequency,
    2.** K complexes cannot be elicited. **
    3.There are marked, irregular
    darting eye movements     and irregular
    darting eye movements    ; dreams and nightmares occur, which may be recalled if the subject is aroused.
  2. Heart rate and BP fluctuate; respiration is irregular.
  3. Muscles are** fully relaxed, but irregular body movements occur occasionally.
    6.     Erection occurs **in males.
  4. About 20–30% of sleep time is spent in REM.
19
Q

CLASSIFICATION OF HYPNOTICS

A
  1. BARBITURATES (long acting, short acting, ultra short acting)
  2. Benziodiazepines (hypnotic, antianxiety, anticonvulsant)
  3. Newer nonbenzodiazepines
20
Q

Drugs under Barbiturates
1. long acting
2. short acting
3. ultra short acting

A

Long acting
* Phenobarbitone

Short acting
* Butobarbitone
* Pentobarbitone

Ultra-short acting
* Thiopentone
* Methohexitone

21
Q

Drugs under Benzodiazepines that are HYPNOTICS

A

**Diazepam **
Flurazepam
Nitrazepam
Alprazolam
Temazepam
Triazolam

22
Q

Drugs under Benzodiazepines that are ANTIANXIETY

A

Diazepam
Chlordiazepoxide
Clorazepate
Oxazepam
Lorazepam
Alprazolam

23
Q

Drugs under Benzodiazepines that are ANTICONVULSANT

A

Diazepam
Lorazepam
Clonazepam
Clobazam

24
Q

Drugs under Newer nonbenzodiazepine hypnotics

A

Zopiclone
Zolpidem
Zaleplon

25
Q

Treatment of ____ is the most important use of this class of drugs.

A

insomnia

26
Q

other drug classification that can be used in treatment of insomnia

A
  1. antihistaminics (promethazine, diphenhydramine)
  2. some** neuroleptic/ antidepressants** (chlorpromazine, amitriptyline)
  3. some anticholinergic (hyoscine) and
  4. opioids (morphine, pethidine)

have significant sedative action, but are not reliable for treatment of insomnia.

27
Q
  • General depressants of the CNS
  • Largely obsolete as anxiolytic- and hypnotic drugs
  • Are also abuse-drugs
  • cause dependence
A

BARBITURATES

28
Q

4 mechanisms by which they barbiturates can cause dependence

A
  1. POSITIVE REINFORCEMENT
  2. CONDITIONING
  3. TOLERANCE- Upregulation of the hepatic cytochrome P450 system (the enzyme system by which they are metabolize
  4. NEGATIVE REINFORCEMENT- Hallucinations
    same as benzodiazepines
29
Q

3 groups of barbiturates

A

A) SHORT-ACTING
B) INTERMEDIATE-ACTING
C) LONG-ACTING

29
Q

3 groups of barbiturates

A

A) SHORT-ACTING
B) INTERMEDIATE-ACTING
C) LONG-ACTING

30
Q

Group of barbiturates:
Short, Intermediate or long acting

  • Less than 1 hour
  • examples are METHOHEXITAL and THIOPENTAL
A

Short-acting

31
Q

Indication: Induction of general anesthesia

  • administered IV
  • lipophilic , thus accumulate in adipose tissue over time
A

METHOHEXITAL

32
Q

Side effect of Methohexital

A
  • Euphoria
  • Drowsiness (sedation)
  • Respiratory depression
  • Cardiovascular depression
  • Death (if overdosed)
33
Q

Group of barbiturates:
Short, Intermediate or long acting

  • 1-6 hours
  • examples are PENTOBARBITAL and BUTOBARBITAL
A

INTERMEDIATE-ACTING

34
Q
  • This drug is used for treatment of insomnia and treatment of anxiety
  • Administered orally
  • Not especially lipophilic, thus will not accumulate in adipose tissue
A

PENTOBARBITAL

35
Q

Group of barbiturates:
Short, intermediate or long acting
* 6-12 hours
* example is PHENOBARBITAL

A

LONG-ACTING

36
Q

Used for treatment of epileptic convulsions

A

PHENOBARBITAL

37
Q

to act primarily at the GABA :BZD receptor–Cl¯ channel complex and* potentiate GABAergic inhibition* by increasing the lifetime of Cl¯ channel opening induced by GABA

A

Barbiturates

PHARMA (29 decks)

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