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Jaspie - Pharmacology > 36 - Sedative-Hypnotic drugs > Flashcards

36 - Sedative-Hypnotic drugs Flashcards

1
Q

Identify drug class:

Pampatulog

A

Hypnotics

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2
Q

Better safety profile:

Barbiturates or Benzodiazepines?

A

Benzodiazepines

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3
Q

MOA of Benzodiazepines

A

Increased FREQUENCY of Cl channel opening

FREnzodiazepine

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4
Q

MOA of Barbiturates

A

Increased DURATION of Cl channel opening

BarbiDURATes

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5
Q

CNS inhibitory NT

A

GABA

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6
Q

PNS inhibitory NT

A

Glycine

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7
Q

Excitatory NT

A

Glutamate (CNS)

Aspartate

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8
Q

Increases frequency of chloride channel opening
Intermediate-acting drug for seizure disorders, tranquilizer
SE: anterograde amnesia, unwanted daytime sedation
Additive CNS depression with alcohol

Drug?

A

Lorazepam
(Alprazolam, Clonazepam)

LAHAT NG -ZEPAM

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9
Q

Increases frequency of chloride channel opening
Short-acting drug for acute anxiety, anesthesia induction, preop sedation
SE: anterograde amnesia, unwanted daytime sedation, rebound insomnia/anxiety
Additive CNS depression with alcohol

Drug?

A

Midazolam

LAHAT NG -ZOLAM

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10
Q

How can benzodiazepine use affect sleep?

A

Decreases REM sleep

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11
Q

Increases frequency of chloride channel opening
Long-acting drug for seizure disorders, tranquilizer, alcohol withdrawal
SE: anterograde amnesia, decreased psychomotor skills, unwanted daytime sedation
Additive CNS depression with alcohol

Drug?

A

Diazepam

Flunitrazepam

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12
Q
  • This long acting benzodiazepine is used as a date-rape drug
  • Enumerate other date-rape drugs (2). Which of these is most commonly used?
A
  • Flunitrazepam (Roofies/Rohypnol)

- Other date rape drugs: alcohol (most commonly used), gamma-hydroxybutyrate

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13
Q

Benzodiazepine with the longest half life

A

Chlordiazepoxide (36-200h)

longest acting, also has the longest spelling

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14
Q

The toxic dose of benzodiazepines is how many times more than its therapeutic dose?

A

1000x

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15
Q

Antidote for Benzodiazepine Toxicity
SE: dizziness, nausea, withdrawal in those with dependence
Seizure and arrhythmia can occur when taken with TCAs

Drug, Class

A

Flumazenil, Benzodiazepine receptor antagonist

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16
Q

Role of activated charcoal im benzodiazepine toxicity

A

NONE. It’s useless

17
Q

Increases duration of chloride channel opening
Short and intermediate acting drug for insomnia, preop sedation
SE: higher likelihood of dependence than benzodiazepines, acute intermittent porphyria
Additive CNS depression with alcohol
Potent inducer of CYP450

Drug, Class

A

Pentobarbital, Barbiturate

LAHAT NG -BARBITAL

18
Q

Ultrashort acting
Increases duration of Chloride channel opening
Drug for anesthesia induction, increased ICP
SE: higher likelihood of dependence than benzodiazepines
Contraindicated in Acute Intermittent Porphyria
Additive CNS effects with ethanol
Potent indicer of CYP450

Drug, Class

A

Thiopental, Barbiturate

TAYO agad THIOpental

19
Q

Increases duration of chloride channel opening
Long acting drug for seizure disorders, status epilepticus, hyperbilirubinemias (Gilbert’s Syndrome)
SE: higher likelihood of dependence than benzodiazepines, acute intermittent porphyria
Additive CNS depression with alcohol
Potent inducer of CYP450
Safe for pregnant*

A

Phenobarbital*, barbiturate

Mephobarbital, Primidone*

20
Q

Enzyme deficient in Porphyria

A

HMB Synthase

21
Q

Selectively binds to GABA-A
Drug for insomnia (for sleep initiation)
SE: less likelihood of dependence than benzodiazepines
Effects reversed with Flumezanil
No anti-convulsant, anti-anxiety, and muscle relaxant effects

A

Zolpidem, Newer hypnotic (Imidazopyridine)
(Zaleplon, Ezopiclone)

Zolpidem, Zaleplon for Zleeeep

22
Q

Identify drug class:

Pampakalma

23
Q 
Partial agonist at 5HT1A and possibly D2 receptors
Drug for Generalized Anxiety Disorder
Good safety profile
Minimal CNS depressant effects
Minimal abuse liability
Minimal tolerance and withdrawal
A

Buspirone

BUSpirone for BUSy people (anxious)

24
Q

Enumerate: Barbiturates

A

Thiopental
Pentobarbital
Phenobarbital

25
Q

Enumerate: Benzodiazepines

A

Midazolam
Lorazepam
Clonazepam

26
Q

What is the most catastrophic symptom of sedative-hypnotic withdrawal?

A

Rebound suicide

27
Q
  • Activates melatonin receptors (MT1 and MT2 receptors) in the suprachiasmatic nuclei in the CNS, causing decreased latency of sleep onset
  • Used for insomnia
  • with minimal rebound insomnia or withdrawal symptoms, minimal abuse liability
A

Ramelteon (Anxiolytic drug: melatonin receptor agonist)

Jaspie - Pharmacology (16 decks)

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