4.6 Sedatives and Hypnotics (KMW)

Question 0

Should pregnant women take sedative-hypnotics?

Answer 0

no. they all cross the placenta and are in breast milk

(actually, she listed out some different classes that we don’t need to know yet. some of these are less harmful to the fetus, but we don’t need to know which ones yet.)

Question 1

when GB binds the channel opens and Cl- enters. This causes _________(hyper or depolarization?)

Answer 1

hyperpolariztion—>decrease in action potential firing—–>decrease in neurotransmitter release—->sedation

Question 2

MOA: increases FREQUENCY of GABAa receptor

barbituates or benzos?

Answer 2

benzodiazepines

Question 3

MOA: increases the DURATION of GABAa receptor Cl- channel opening

(barbituates or benzos?)

Answer 3

barbituates

Question 4

List 6 places where GABA inhibition occurs

Answer 4

spinal cord
hypothalamus
hippocampus
substantia nigra
cerebellar cortex
cerebral cortex

Question 5

are benzos or barbituates more danger (which has a greater risk of a fatal overdose due to the slow metabolism and long 1/2 life?)

Answer 5

Barbituates.

note the graph on slide 3. barbituates are drug A. they don’t taper off before coma and death while benzos tend to taper off between anesthesia and hypnosis.

Question 6

where do barbituates allerosterically bind the ion channel?

benzodiazepines?

newer hypnotis?

Answer 6

barbituates: beta and alpha
benzodiazepines: alpha only
newer: alpha only (newer hypnotics are like Benzo but are more specific for the alpha subunit)

Question 7

what is the effect of a newer hypnoti?

Answer 7

hypnotic only.
no sedation
no anesthesia
no antiseizure

Question 8

describe the reservoir effect

Answer 8

drugs can hang out in adipose then ooze back into regular circulation at unpredictable times not on the dosing schedule

Question 9

Which drug-drug interactions are dangerous for sedative-hypnotics

Answer 9

alcohol and anti-histimines have an additive effect

Question 10

Patient presents with increased anxiety, insomnia, and seizures. What type of drug are they likely withdrawing from?

Answer 10

sedative-hypnotic

Question 11

which populations have a longer 1/2 life for sedative-hypnotics

Answer 11

women and the elderly