Anxiety (+ sedatives)

Question 1

Diazepam MoA

Answer 1

Enhances activation of GABA at GABA receptors by increasing Cl- permeability

Question 2

Diazepam clinical effects

Answer 2

Reduces anxiety and depression
Produce sedation and induce sleep
Reduce muscle tone and coordination
Anticonvulsant effect

Question 3

Diazepam AE

Answer 3

Drowsiness, confusion, ataxia, ante-retrograde amnesia, tolerance, dependence, vertigo, dizziness

Question 4

Very short acting sedative

Answer 4

Midazolam (<6hrs; conscious sedation)

Question 5

Short acting sedative

Answer 5

Temazepam (6-12hrs; insomnia)

Question 6

Medium acting sedative

Answer 6

Lorazepam (12-24hrs; anxiety/insomnia)

Question 7

Long acting sedative

Answer 7

Diazepam (>24hrs; anxiety, epilepsy prophylaxis, central muscle relaxant)

Question 8

Sedative effects

Answer 8

Calming effect, reduces anxiety, little/no effect on mental function, benzodiazepines

Question 9

Hypnotic effects

Answer 9

Drowsiness to encourage sleep

Question 10

Thipentone MoA

Answer 10

Increased potentiation of GABA effects at receptors
Short duration (works in 10-20 seconds, lasts 5-10 minutes)

Question 11

Propofol MoA

Answer 11

Unknown - thought to mimic GABA or potentiate its actions

Half-life = 30-60 minutes

Question 12

Propofol AE

Answer 12

Anti-emetic effect, hypotension

Question 13

Ketamine MoA

Answer 13

Non-competitive antagonist of excitatory glutamate NMDA receptors
Rapid induction, short duration

Question 14

Ketamine AE

Answer 14

Hypertension, tachycardia, increased muscle tone, increase ICP and intraocular pressure, nausea, vomiting, arrhythmia, anaphylaxis, chronic use can cause UT symptoms, hallucinations, delirium

Question 15

Midazolam MoA

Answer 15

Enhances activation of GABA at GABA receptors by increasing Cl- permeability

Question 16

Midazolam AE

Answer 16

Ante-retrograde amnesia, CVS or respiratory depression when taken with opioids, alcohol, resp. disease, hypotension, hiccup, cough, nausea, vomiting, headache, confusion, restlessness, tolerance

Question 17

Inhaled anaesthesia

Answer 17

Gas or volatile liquids

Thought to work due to activation of TREK-1 channels -> hyperpolarisation of neurons

Question 18

Blood gas partition coefficient - high coefficient meaning

Answer 18

Higher amount of drug in blood -> slower induction

E.g. halothane

Question 19

Blood gas partition coefficient - low coefficient meaning

Answer 19

Lower amount of drug in blood -> faster induction

E.g. nitrous oxide