9. Anxiolytic and Hypnotic Drugs Flashcards

1
Q

What are the key types of anxiolytic and hypnotic drugs?

A

Benzodiazepines, barbiturates.

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2
Q

What is the naming rule of benzodiazepines? Name 3 examples.

A

Normally ends in -lam or -pam. Diazepam, lorazepam, temazepam.

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3
Q

Name the benzodiazepine antagonist drug.

A

Flumazenil.

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4
Q

What is the naming rule of barbiturates? Name 2 examples.

A

Ends in -barbital. Phenobarbital, amobarbital, pentobarbital.

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5
Q

What is the mechanism of action of benzodiazepines?

A

Modulate GABA effects (allow Cl- through pore for hyperpolarisation and decreased neurotransmission from neurone) to increase them.

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6
Q

What are the actions of benzodiazepines?

A

Reduce anxiety, sedative/hypnotic, anterograde amnesia, anticonvulsant, muscle relaxant.

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7
Q

How are benzodiazepines anxiolytic?

A

Selectively enhance GABAergic transmission to inhibit neuronal circuits in limbic system of the brain.

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8
Q

How can benzodiazepines cause muscle relaxation?

A

High doses - increase presynaptic inhibition in spinal cord.

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9
Q

What are the therapeutic uses of benzodiazepines?

A

Severe anxiety, sleep disorders, amnesia, seizures, muscular disorders.

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10
Q

Are benzodiazepines lipophilic and/or hydrophilic? What is the implication of this on absorption?

A

Lipophilic. Means they’re rapidly and completely absorbed after oral administration.

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11
Q

How are most benzodiazepines metabolised?

A

Hepatic system metabolises them, excreted in urine.

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12
Q

What is a risk of long term benzodiazepine use? What reduces the harm of this?

A

Dependence. Doses should be stopped very gradually.

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13
Q

What are the common side effects of benzodiazepines?

A

Drowsiness and confusion. Ataxia at high doses. Cognitive impairment.

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14
Q

What is the mechanism of action of barbiturates?

A

Sedative-hypnotic action by enhancing GABAergic transmission and prolonging the duration of chloride channel openings. Also block excitatory glutamate receptors.

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15
Q

What are the adverse actions of barbiturates?

A

Depression of CNS - sedation at low doses, hypnosis-anaesthesia-coma-death at high doses; respiratory depression.

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16
Q

What are the therapeutic actions of barbiturates?

A

Anaethesia, anticonvulsant, sedative/hypnotic.

17
Q

How are barbiturates metabolised and excreted?

A

Metabolised by liver, excreted in urine.

18
Q

What are the adverse effects of barbiturates?

A

Drowsiness, impaired concentration, P450 enzyme induction, tremor, nausea, potential for addiction.

19
Q

What are the withdrawal effects of barbiturates?

A

Tremors, anxiety, weakness, restlessness, nausea, vomiting, seizures, delirium, cardiac arrest.

20
Q

What are the therapeutic advantages of benzodiazepine use?

A

Potential use in chronic therapy for seizures, less potent and slowly eliminated so no rebound insomnia on discontinuation, agent of choice for panic disorders, fewer drug interactions as no phase I metabolism and can be used in patients with hepatic impairment.

21
Q

What are the therapeutic disadvantages of benzodiazepine use?

A

May disturb intellectual functioning and motor dexterity, potential for dependence and withdrawal seizures.