8.1: Drug of Abuse Flashcards

1
Q
  • No medical indication
  • Abuse vs Misuse
  • Euphoria
  • Altered perception
  • “Compulsive” 🡪 Addiction
A

Drug of Abuse

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2
Q

Identify if Dependence or Addiction:

  • Physical
  • Tolerance
  • Withdrawal Syndrome
A

Dependence

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3
Q

Identify if Dependence or Addiction:

  • Psychological
  • Compulsion
  • Relapsing
  • Craving
A

Addiction

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4
Q

Identify what Regulation Schedule:

High potential for abuse, no known medical use and lacks accepted safety for use.

A

Schedule I

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5
Q

What are the examples of Schedule I?

A
  • Heroin
  • Lysergic acid diethylamide
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6
Q

Identify what Regulation Schedule:

Potential for abuse with proven and accepted medical use but WITH SEVERE RESTRICTIONS, because abuse may cause severe psycho/physio dependence.

A

Schedule II

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7
Q

What are the examples of Schedule II?

A
  • Morphine
  • Cocaine
  • Methadone
  • Methampetamine
  • Phencyclidine

MoCoMeMeP

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8
Q

Identify what Regulation Schedule:

  • Less potential for abuse than schedule I or II; with accepted medical use
  • Abuse may cause moderate or low physical dependence or high psychological dependence
A

Schedule III

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9
Q

Regulation Schedule:

What are the examples of Schedule III?

A
  • Anabolic steroids
  • Codeine with hydrocodone
  • Aspirin or Tylenol
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10
Q

Identify what Regulation Schedule:

  • The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule III
  • Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule III
A

Schedule IV

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11
Q

What are the examples of Schedule IV?

A
  • Valium
  • Xanax
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12
Q

Identify what Regulation Schedule:

  • The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule IV
A

Schedule V

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13
Q

Regulation Schedule:

What are the examples of Schedule V?

A
  • Cough syrups
  • Codeine
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14
Q

What are the pharmacokinetic tolerance?

A
  • Reduction of concentration
  • Shorter duration of action
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15
Q

What are the pharmacodynamic tolerance?

A
  • Recruitment of Adaptor protein (β-arrestin)
  • Desensitization
  • Receptor internalization
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16
Q

Enumerate the withdrawal symptoms:

A
  • Restlessness
  • Eating more than usual
  • Excessive hunger
  • Anxiety/tension
  • Impatience
  • Depression
  • Disorientation
  • Loss of energy/fatigue
  • Tremors
  • Craving for cigarettes
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17
Q

This is a high motivation to obtain and use and has a negative consequences.

A

Addiction

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18
Q

They revert back because of the environment and drug availability. It has re-exposure, stress, and context recall.

A

Relapse

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19
Q

This alter perception and has no reward/euphoria. It targets cortical and thalamic system.

A

Nonaddictive Drug of Abuse

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20
Q

Examples of nonaddictive drug of abuse:

A
  • Hallucinogens
  • Dissociative anesthetics
  • LSD
  • PCP/Ketamine
  • Dextromethorphan
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21
Q

What are the Class I drugs that Activate G-protein coupled receptors?

A
  • GHB
  • LSD, Mescaline & Psilocybin
  • Opioids
  • Cannabinoids

GLOC :3

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22
Q

What are the Class II drugs that Bind to Ionotropic receptors?

A
  • Nicotine
  • Benzodiazepines
  • Alcohol
  • Ketamine & PCP
  • Inhalants

NiBAKIn

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23
Q

What are the Class III Drugs that Bind to Transporters of Biogenic Amines?

A
  • Cocaine
  • Amphetamines
  • Ecstasy (MDMA)
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24
Q

Identify this nonaddictive drug abuse:

  • Strong analgesics
  • Opiates – morphine, codeine, thebaine, papaverine
  • Narcotic – “sleep inducing”
  • Leads to respiratory arrest
A

Opioids

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25
Q

Identify the opioid receptor subtypes:

  • Supraspinal and spinal analgesia
  • Sedation
  • Inhibition of respiration
  • Slowed gastrointestinal transit
  • Modulation of hormone and neurotransmitter release
A

µ (mu)

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26
Q

Identify the opioid receptor subtypes:

  • Supraspinal and spinal analgesia
  • Modulation of hormone and neurotransmitter release
A

δ (delta)

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27
Q

Identify the opioid receptor:

  • Supraspinal and spinal analgesia
  • Psychotomimetic effects
  • Slowed gastrointestinal transit
A

κ (kappa)

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28
Q

What are the common opioid analgesics that are strong agonist (+++,++, ++)?

A
  • Morphine
  • Oxycodone
  • Hydromorphone
  • Oxymorphone
  • Methadone
  • Meperidine
  • Fentanyl
  • Sufentanil
  • Alfentanil
  • Remifentanil
  • Levorphanol

MOHOMMFeSARL :D

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29
Q

What are the common opioid analgesics that are partial or weak agonist (±)?

A
  • Buprenorphine
  • Butorphanol
  • Codeine
  • Hydrocodone
  • Pentazocine

BuBuCoHyP :P

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30
Q

What are the common opioid analgesics that are antagonist (-)?

A

Nalbuphine

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31
Q

Plant source of opioids:

A

Papaver somniferum

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32
Q

True or False:

Opioids is a powerful narcotic painkiller where the principal active ingredient is morphine.

A

True

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33
Q

Mode of administration of opioids:

A

Subcutaneous, Intravenous

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34
Q

Effects of opioids:

A

Insomnia, hallucination, nightmares

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35
Q

True or False:

Opioids is a histamine release and have more pronounced effects than heroin.

A

True

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36
Q

It is a diamorphine addictive drug as a white or brown powder that tends to be used with other drugs.

A

Heroin

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37
Q

Mode of administration of Heroin:

A

Fast-acting; Intravenous

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38
Q

What is the half-life of heroin?

A

3-5 hours, several doses per day

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39
Q

Hours of withdrawal of heroin:

A

5-10 hours after

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40
Q

It is derived from codeine and synthesized from thebaine. This type of drug is in tablet or oral form.

A

Oxycodone

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41
Q

This type of drug has a serious interaction with MAO’s, and has resulted in MPTP which can cause parkinsonism.

A

Meperidine (pethidine; Demerol)

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42
Q

Degrees of tolerance:

What are the effects of high degree of opioid efficacy?

A
  • Analgesia
  • Euphoria, dysphoria
  • Mental clouding
  • Sedation
  • Respiratory depression
  • Antidiuresis
  • Nausea and vomiting
  • Cough suppression
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43
Q

Degree of tolerance:

What are the effects of moderate degree of opioid efficacy?

A

Bradycardia

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44
Q

Degrees of tolerance:

What are the effects of minimal or none degree of opioid efficacy?

A
  • Miosis
  • Constipation
  • Convulsions
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45
Q

What are the adverse effects of opioid analgesics in acute use?

A
  • Respiratory depression
  • Nausea/vomiting
  • Pruritus
  • Urticaria
  • Constipation
  • Urinary retention
  • Delirium
  • Sedation
  • Myoclonus
  • Seizures
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46
Q

What are the adverse effects of opioid analgesics in chronic use?

A
  • Hypogonadism
  • Immunosuppression
  • Increased feeding
  • Increased growth hormone secretion
  • Withdrawal effects
  • Tolerance, dependence
  • Hyperalgesia
  • Impairment while driving
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47
Q

Identify what drug group based on the interaction with opioids

Increased CNS depression, particularly respiratory depression.

A

Sedative-hypnotics

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48
Q

Identify what drug group based on the interaction with opioids:

Increased sedation, variable effects on respiratory depression. Accentuation of cardiovascular effects (antimuscarinic and α-blocking actions).

A

Antipsychotic agents

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49
Q

Identify what drug group based on the interaction with opioids:

Relative contraindication to all opioid analgesics because of the high incidence of hyperpyrexic coma; hypertension is also reported.

A

Monoamine oxidase inhibitors

50
Q

Identify the opioid drug interaction

  • alcohol, barbiturates, benzodiazepines, gamma-hydroxybutyric acid (GHB)
  • can be short- to long-acting
  • the longer the duration the less the withdrawal
  • anxiety, tremors, twitches, vomiting
A

Sedative-hypnotics

51
Q

Clinical uses of sedative-hypnotics:

A
  • Relief of anxiety
  • Insomnia
  • Sedation and amnesia before and during medical and surgical procedures
  • Treatment of epilepsy and seizure states
  • Component of balanced anesthesia (IV administration)
  • Control of ethanol or other sedative-hypnotic withdrawal states
  • Muscle relaxation in specific neuromuscular disorders
  • Diagnostic aids or for treatment in psychiatry
52
Q

Identifythis nonaddictive drug use:

  • rare occurrence of physiologic dependence
  • “Therapeutic Dose Dependence”
  • weight loss, change in perception, paresthesia, headache
A

Benzodiazepines

53
Q

What type of benzodiazepine drug is used for date rape and has a Schedule IV and anterograde amnesia?

A

Flunitrazepam (Rohypnol)

54
Q
  • GABAa receptors
  • usually short-acting drugs
  • not used as much as other drugs
A

Barbiturates

55
Q

Example of drugs of barbiturates:

A

Secobarbital, pentobarbital Na

56
Q

Identify this non-addictive drug of abuse:

  • euphoria
  • Alcoholism
  • Affect GABAa and NMDA
  • withdrawal (motor agitation, anxiety, insomnia, hallucination, abnormal vital signs, seizures)
A

Alcohol

57
Q

Identify this nonaddictive drug abuse:

  • GABAb
  • naturally found in body
  • can be found in fermented drinks like guava (Psidium guajava)
  • euphoric, sedative, anabolic
  • widely sold until 1992
  • liquid ecstasy, soap, easy lay, vita-G
  • Georgia homeboy
  • use with alcohol can produce breathing problems
A

Gamma Hydroxybutyric Acid

58
Q

What are the withdrawal effects of Gamma Hydroxybutyric Acid?

A

Insomnia, anxiety, tremors, sweating

59
Q

What is the treatment for short and long acting drugs?

A

Chlordiazepoxide or Phenobarbital

60
Q

What is the treatment for alcohol?

A

Disulfiram, naltrexone

61
Q

Plant source of Cannabinoids:

A

Cannabis sativa

62
Q

Identify this nonaddictive of abuse:

  • CB1 receptors
  • Can be smoked or joined with ingredients in making brownies or fermented products (beer)
  • Effects in 2-3 inhalations (“high,” euphoria, laughter, relaxation)
  • Schedule I
A

Cannabinoids

63
Q

Identify this drug:

  • Antiemetic
  • tolerance
  • uncertain effect on fetus
  • Amotivational syndrome
  • diseases related to smoking
A

Marijuana

64
Q

Examples of Cannabinoids:

A
  • Dronabinol
  • Nabilone (chemotherapy)
  • Nabiximol (MS)
65
Q

What are the four hallucinogens that cause hallucinations?

A
  • LSP
  • PCP
  • Ketamine
  • Scopolamine
66
Q

Plant source of LSD:

A

Claviceps purpurea

67
Q

Identify what hallucinogens:

  • synthetic agent related to ergot alkaloids
  • NE, dopamine, serotonin
  • 5-HT1a & 5-HT1c agonists
  • one of the most potent drugs 1ug/kg
  • absence of known fatalities
  • duration based on dose
  • waxing and waning effects
A

LSD (Lysergic acid diethylamide)

68
Q

Identify what Hallucinogen based on its effects:

  • rise in body temp
  • Hallucinations
  • uterine contractions
  • elevated sugar levels
  • goosebumps
  • Euphoria
  • pupil dilation
A

Lysergic acid diethylamide (LSD)

69
Q

Plant source of Mescaline:

A

Lophophora williamsii

70
Q

Identify what hallucinogens:

  • restricted but allowed occasionally to North American Indians
  • 5-6mg/kg
A

Mescaline

71
Q

Identify what hallucinogen:

  • 250ug/kg
  • mydriasis, muscle relaxation, dizziness
A

Psilocybin

72
Q

Plant source of Psilocybin:

A

Psilocybe mushroom

73
Q

Identify what hallucinogen:

  • anesthetic
  • “special K” “vitamin K”
  • dream-like states, hallucination, delirium, amnesia, high BP, depression,
  • fatal respiratory problems
A

Ketamine

74
Q

Identify what hallucinogen:

  • veterinary anesthetic
  • smoked with tobacco, snorted
  • MOA: Oral, IV
  • antagonize NMDA
  • animals will self administer it
  • Olney’s lesions
  • long t1/2
  • users tend to be violent and suicidal
  • “bad-trips”
A

Phencyclidine (angel dust, PCP)

75
Q

Plant source of Scopolamine:

A

Hyoscyamus niger

76
Q

Identify what hallucinogen:

  • block central muscarinic receptors
  • unpleasant to users
  • same effects as other hallucinogen
  • “Devil’s breath”
A

Scopolamine

77
Q

Plant source of Cocaine:

A

Erythroxylon coca

78
Q

Identify what hallucinogen:

  • dopaminergic reuptake transmitter
  • inhibit reuptake of dopamine and NE
  • free base is absorbed as fast as IV
  • t1/2= 1hr, repeated 30min
A

Cocaine

79
Q

Identify what hallucinogen based on its effects:

  • symptoms include a feeling of bugs under skin
  • paranoia and schizophrenia like state
  • exhaustion by lack of sleep and food appetite, exhaustion, depression
A

Cocaine

80
Q

Identify what hallucinogen:

  • increase catecholinergic neurotransmitters
  • dopamine not be metabolized thus released
  • treat narcolepsy and ADHD
  • paranoid psychosis
  • necrotizing arteritis
  • OD is rarely fatal
  • managed by benzodiazepines
A

Amphetamines

alpha-methyl-phenethylamine

81
Q

Identify what hallucinogen:

  • Schedule II
  • decreased appetite, increase stamina, energy sexual drive
  • loss of REM sleep, tremor, restlessness, anxiety,
  • related drugs (shabu, ecstasy)
A

Amphetamines

82
Q

What are the drugs that targets the NMDA receptor antagonist?

A

Phencyclidine, ketamine

83
Q

What is the drug that targets acetylcholine receptor agonist (nAChr)?

A

Nicotine

84
Q

What are the drugs that reverses transport of serotonin receptor (SERT) > dopamine receptor (DAT) and norepinephrine receptor (NET)?

A

Ecstasy

85
Q

What is the drug that inhibits dopamine receptor (DAT), serotonin receptor (SERT), and norepinephrine receptor (NET)?

A

Cocaine

86
Q

What is the drugs that reverses transport of dopamine receptor (DAT), norepinephrine receptor (NET), serotonin receptor (SERT), and vesicular monoamine transporter (VMAT)?

A

Amphetamine

87
Q

What is the drug that targets the GABAa receptor positive modulator?

A

Benzodiazepines

88
Q

What is the drug that targets the GABAa receptor positive modulator, 5-HT3 receptor, nAChR, NMDAR, Kir3 channels?

A

Alcohol

89
Q

What is the drug that targets 5-HT(2A)R partial agonist?

A

LSD, mescaline, psilocybin

90
Q

What is the drug that targets μ (Mu) receptor agonist?

A

Opioids

91
Q

What is the drug that targets CB1 receptor agonist?

A

Cannabinoids

92
Q

What is the drug that targets GABAb receptor weak agonist?

A

γ-Hydroxybutyric acid (GHB)

93
Q

Identify this substance of abuse:

  • “uppers”
  • reverse the effects of fatigue on both mental and physical tasks.
  • Nicotine - tobacco products
  • Caffeine - coffee, tea, some soft drinks, and many non-prescription medicines
A

Stimulants

94
Q

Plant source of Nicotine:

A

Nicotiana tobacum

95
Q

Identify this substance of abuse:

  • nicotinic cholinergic receptor agonist
  • 1 drop is fatal
  • strong psychological and physiological dependence (more addictive than heroin and cocaine)
  • dopamine
  • SIDS, carcinogenic
A

Nicotine

96
Q

Identify this substance of abuse:

  • adenosine receptors
  • low chance of abuse and addiction
  • 5 cups/ day
A

Caffeine (1, 3, 7-trimethylxanthine)

97
Q

Identify this substance of abuse:

  • anesthetic gases
  • industrial solvents
  • aerosol propellants
  • organic nitrites
A

Inhalants

98
Q

Identify this substance of abuse:

  • psychoactive effects
  • alcohol-like intoxications, hallucinations,
  • hypoxia, pneumonia, cardiac failure
  • headache, nausea, vomiting, slurred speech, loss of motor coordination, wheezing
A

Inhalants

99
Q

Identify this substance of abuse:

  • difficulty in concentrating, dreaminess, euphoria, numbness, tingling
  • N2O = 35% used; 100% death
  • ether & chloroform
A

Anesthetics

100
Q

Identify this substance of abuse:

  • gasoline, toluene, benzene, trichloro-ethylene
  • 5-15min
  • euphoria, “drunk” feeling, disorientation (slow passage of time)
  • Eg. Glue, correction fluid, gas
A

Industrial solvents

101
Q

Identify this substance of abuse:

  • amyl nitrite, isobutyl nitrite
  • dizziness, rapid heart rate, lowered BP, “speeding,” flushing of skin
  • enhance, prolong erection
A

Organic nitrites

102
Q

Identify this substance of abuse:

  • Liver, kidney, peripheral nerve, and brain damage
  • bone marrow suppression
  • pulmonary disease
  • death
A

Toxicities

103
Q

Identify this substance of abuse:

  • cyclopentanoperhydrophenanthrene ring
  • bone growth, appetite, puberty, muscle growth
  • Schedule III
  • change in libido, irritability, violence, mood swings, forgetfulness, confusion
  • fatigue, depressed mood, craving for steroids
A

Anabolic Steroids

104
Q

Identify this substance of abuse:

  • hypertrophied muscles, acne, oily skin, hirsutism in females, gynecomastia in males, needle punctures
  • high LDL; low HDL
  • elevated liver function
A

Anabolic Steroids

105
Q

A nonselective antagonist drug that is used for opioid overdose.

A

Naloxone

106
Q

An antagonist drug that is used for treatment for alcoholism, opioid addiction.

A

Naltrexone

107
Q

A slow-acting agonist of μ-opioid receptor that is used for substitution therapy for opioid addicts.

A

Methadone

108
Q

An “enantiopure” methadone containing only the left-enantiomer of the molecule that is used for substitution therapy.

A

Levomethadone

109
Q

A salt containing morphine sulfate pentahydrate that is used for substitution therapy.

A

Morphine sulphate

110
Q

A partial agonist at μ-opioid receptors that is used for oral substitution therapy for opioid addicts.

A

Buprenorphine

111
Q

A partial agonist of nicotinic acetylcholine receptor that is used for smoking cessation.

A

Varenicline

112
Q

A positive modulator of the GABAa receptors that increases frequency of channel opening and is used for delirium tremens.

A

Oxazepam

113
Q

An antagonist of NMDA glutamate receptors that is used for treatment of alcoholism.

A

Acamprosate

114
Q

A CB1 receptor inverse antagonist drug that is used to treat obesity but withdrawn, smoking cessation but not approved, but remains an off-label indication.

A

Rimonabant

115
Q

An agonist melatonin receptor hypnotic drugs that is used for patients who have difficulty in falling asleep, and is located in the suprachiasmatic nuclei of the brain.

A

Ramelteon

116
Q

A 5-HT receptor partial agonist drug that has a slow-onset of anxiolytic effects and has a minimal psychomotor impairment.

A

Buspirone

117
Q

An orexin antagonist that blocks the binding of orexins, neuropeptides that promote wakefulness.

A

Suvorexant

118
Q

Newer hypnotics that bind selectively to GABAa subgroup receotors, acting like Benzodiazepines to enhance membrane hyperpolarization.

A
  • Eszopiclone
  • Zaleplon
  • Zolpidem
119
Q

Barbiturate drugs that is a dose-dependent depressant effects on the CNS and has a steeper dose-response relationship than Benzodiazepines.

A
  • Amorbital
  • Butabarbital
  • Mephobarbital
  • Pentobarbital
  • Phenobarbital
  • Secobarbital
120
Q

An antagonist drug at benzodiazepine-binding sites on the GABAa receptor.

A

Flumazenil

121
Q

Benzodiazepine drugs that is a dose-dependent depressant effects on the CNS.

A
  • Alprazolam
  • Chlordiazepoxide
  • Clonazepam
  • Clorazepate
  • Diazepam
  • Estazolam
  • Fluazepam
  • Lorazepam
  • Midazolam
  • Oxazepam
  • Quazepam
  • Temazepam
  • Triazolam

bwct basta puro am last

122
Q

A barbiturate drug that is lipid-soluble, intravenous administration, and use for the induction of anesthesia.

A

Thiopental and methohexital