Alcohol, Anxiolytics, & Sedative Hypnotics

Question 0

Fomepizole MOA

Answer 0

inhibits alcohol DH

Question 1

Disulfram MOA

Answer 1

inhibits aldehyde DH

Question 2

product of alcohol DH?

Answer 2

acetaldehyde

Question 3

product of aldehyde DH

Answer 3

acetate

Question 4

alcohol MOA (4)

Answer 4

binds to GABAa receptor to increase Cl- influx
increases DA in mesolimbic pathway
inhibits the effect of glutamate on NMDA receptor
increases NMDA receptors

Question 5

naltrexone contraindication

Answer 5

liver failure

Question 6

naltrexone MOA

Answer 6

opioid antagonist- blocks alcohol’s ability to stimulate the reward pathway

Question 7

acamprosate (camprel EC) MOA

Answer 7

structural analogue of GABA- restores balance of GABA and glutamate

Question 8

antidote for MeOH poisoning

Answer 8

fomepizole- alcohol DH inhibitor

Question 9

short-acting barbiturate used for anesthesia induction

Answer 9

thiopental (pentothal)

Question 10

long-acting barbiturate, used as anticonvulsant

Answer 10

phenobarbital (Luminal)

Question 11

barbiturate contraindications (3)

Answer 11

porphyria
pulmonary insufficiency
alcohol

Question 12

short-acting benzo

Answer 12

midazolam

Question 13

long-acting benzos (4)

Answer 13

diazepam
prazepam
clorazepate
fluzepam

Question 14

short-acting benzos (3)

Answer 14

alprazolam
triazolam
lorazepam

Question 15

benzo MOA (2)

Answer 15

bind to the GABAa receptor

increase affinity of the receptor to GABA, prolonging its action

Question 16

benzo tx insomnia (2)

Answer 16

flurazepam
temazepam

helpful for people who can’t fall asleep

Question 17

benzo tx status epilepticus (2)

Answer 17

diazepam

lorazepam

Question 18

benzo sedation/anesthesia

Answer 18

midazolam

Question 19

benzo for muscle spasm

Answer 19

diazepam

Question 20

benzo for EtOH withdrawl (3)

Answer 20

taper w/
chlordiazepoxide
diazepam
lorazepam

Question 21

benzo contraindications? (2)

Answer 21

pregnancy

sleep apnea

Question 22

benzo antagonist & MOA

Answer 22

flumazenil
antagonist- competes for GABA receptor
reverses effects of benzos

Question 23

flumazenil contraindication

Answer 23

hx seizures

Question 24

“Z drugs” & MOA

Answer 24

Zolpidem (Ambien), Zaleplon (Sonata), Eszopiclone (Lunesta)

bind to the BZ1 subtype of the GABA receptor to increase GABA mediated inhibition

Question 25

eszopiclone use?

Answer 25

long-half life, long-term tx

Question 26

Ramelteon (Rozerem) MOA

Answer 26

melatonin analogue, promotes sleepiness w/ no GABA effect

GABA independent- no ceiling effect

Question 27

Buspirone (BuSpar) MOA & use

Answer 27

partial agonist at post-synaptic serotonin receptor –> inhibition of cell signaling, decreased 5-HT release

relieves anxiety w/o sedation. takes 2 weeks to feel effects
low addiction potential