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IC Part II > Anxiety and Sleep > Flashcards

Anxiety and Sleep Flashcards

1
Q

decreases motor activity, coordination, and mental acuity

A

sedative

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2
Q

increases tendency to sleep from which the patient is easily awakened

A

hypnotic

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3
Q

induces sleep from which the patient is not easily awakened

A

anesthetic

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4
Q
  • produce anesthesia, coma and and death
  • barbiturates
  • ethanol
A

complete CNS depressants

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5
Q
  • typically don’t produce anesthesia and will not induce coma or death alone
  • benzodiazepenes
  • non benzodiazepine, BZ receptor agonists
A

incomplete CNS depressants

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6
Q

Barbiturates bind that barbiturate binding site on the _______ receptor, increasing ______ ion channel flux by increasing channel open time

A

GABAa

chloride

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7
Q

effect of barbiturates on CNS? respiratory and cardiovascular?

A
  • complete CNS depressant

- no effect on cardiovascular up to anesthetic dose

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8
Q

barbiturates induce what type of tolerance?

A

pharmacokinetic (induce CYP450, decrease plasma levels of other drugs)

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9
Q
  • tolerance to this class of drugs develops over time (kinetic and dynamic)
  • addiction common
  • withdrawal - anxiety, tremor, n/v, weight loss, psychosis, seizures, hyperthermia, cardiovascular collapse can be fatal
  • treatment: measured reduction over time (2-3 wks)
A

barbiturates

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10
Q

long acting barbiturate?

A

phenobarbital

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11
Q

pentobarbital and secobarbital are _______ acting barbiturates

A

medium

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12
Q

methohexital and amobarbital are ______ acting barbiturates

A

short, given IV

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13
Q

ultra short acting barbiturate given IV?

A

thiopental

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14
Q

used as sedatives, hypnotics (not 1st line), anticonvulsants, drug induced coma, preanesthetic, anesthetic, WADA test, truth serum, euthanasia

A

barbiturate uses

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15
Q
  • readily diffuse across all membranes
  • redistribution accounts for differences in duration of action
  • cross placenta
  • high bound to plasma proteins (drug interactions)
  • metabolized in liver
  • excreted in urine
A

pharmacokinetics of barbiturates

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16
Q

Benzodiazepines bind to BZ sites on GABAa receptor, increase _______ of GABAa receptor for GABA increasing likelihood of channel opening

A

affinity

17
Q

what underlies the differences in effects of various benzodiazepine compounds?

A

heterogeneity of receptor subunits, different affinities for BZ binding sites

18
Q
  • incomplete CNS depressant
  • decreased anxiety
  • skeletal muscle relaxant
  • anticonvulsant
  • hypnotic
  • tolerance develops to sedative, hypnotic, anticonvulsant actions
  • paradoxical excitement
  • no CV, resp, GI effects
A

effects of diazepam (benzodiazepines)

19
Q
  • sedation and ataxia
  • amnesia
  • nightmares, irritability, anxiety, seizures
  • treat acute overdose with flumazenil
  • withdrawal: rebound anxiety irritability, insomnia, tremor, sweating, anorexia, seizures, psychosis
  • low risk of fatal OD if used alone
A

side effects of benzos (diazepam)

20
Q

midazolam and triazolam are _______ benzodiazepines

A

short acting

21
Q

most rapidly inactivated benzo used for anesthesia IV?

A

midazolam

22
Q

anxiolytic/hypnotic used for panic attacks, rapid oral absorption/onset

A

alprazolam

23
Q

chlordiazepoxide, lorazepam are _____ benzos used as anziolytics/preanesthetic

A

moderate acting

24
Q

long acting benzo used as anticonvulsant?

A

clonazepam

25
Q

very long acting benzo with active metabolites used as anxiolytic, anticonvulsant, muscle relaxant, antispastic, pre-anesthetic?

A

diazepam

26
Q

flurazpeam is a _____ benzo

A

very long acting

27
Q

fast acting, amnestic, date rape drug, no therapeutic use

A

flunitrazepam

28
Q

used to reverse overdose of benzos and anesthesia?

A

flumazenil

29
Q
  • rapidly absorbed from GI
  • admin orally, highly protein bound but few drug interactions
  • cross placenta
  • numerous active metabolites
  • metabolized in liver, excreted in urine
A

benzodiazepines

30
Q
  • BZ1 agonists and non selective
  • hypnotic, short half life, less amnestic than benzos
  • produce less tolerance
  • hallucinations, sleepwalking, amnesia
A

zolpidem, zaleplon, eszopiclone

31
Q

partial agonist at 5-HT1a site, slow onset of action 1-2 wks, dysphoric at high doses

A

buspirone

32
Q

increase synaptic availability of 5-HT, used for GAD and prophylaxis for panic attack

A

SSRIs

33
Q

H1 blocker, pre and post op, antipruritic and antiemetic

A

hydroxyzine

34
Q

MT1/2 melatonin receptor antagonist, indicated for insomnia with prolonged sleep onset

A

ramelteon

35
Q

indicated for difficulties with sleep onset or maintenance, orexin antagonist

A

suvorexant

36
Q

H1 blocker, common OTC sedative

A

diphenhydramine

37
Q

blocks 5HT reuptake, antidepressant but also used as hypnotic

A

trazodone

IC Part II (29 decks)

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