Anxiolytic and Hypnotic Drugs Flashcards
When taking an anxiolytic drug, what effects will you expect to see?
Reduce anxiety/produce a calming effect. Does not depress CNS so doesn’t induce drowsiness
When taking a hypnotic drug, what effects will you expect to see?
Produces drowsiness and encourages sleep. Has a more pronounced effect on CNS depression.
What is the only class of anxiolytic/ hypnotic drug that you can not die on by taking it alone?
Benzodiazepine
What is the safest type of anxiolytic/hypnotic drug taken by itself?
Benzodiazepine
What two classes of anxiolytic/ hypnotic drugs are considered controlled substances?
Benzodiazepenes
Barbituates
What actions do benzodiazepines have?
Reduce Anxiety
Sedative and hypnotic
Anterograde Amnesia - temporary loss of memory of future events
Anticonvulsant- treatment of epilepsy
Muscle Relaxer at high doses
A patient recently underwent cataract surgery and tells you they were put to sleep during the surgery. You know this is false. They were awake but do not remember due to the drug they were given before surgery. What drug class was the patient given?
Benzodiazepines
* Alprazolam (Xanax) * Chlordiazepoxide (Librium) * Clorazepate * Clonazepam (Klonopin) * Diazepam (Valium) * Estazolam * Flurazepam * Lorazepam * Midazolam (Versed) * Oxazepam * Temazepam * Triazolam
What are benzodiazepines metabolized by?
Liver
How are benzodiazepines administered?
Orally or IV
A patient takes a benzodiazepine and is waiting for it to take effect. Would you expect a short or long time frame for it to take effect, why?
Benzodiazepines have a short time to take effect because they have a short latency to action and enters the brain very quickly.
What is something unique about the metabolism of benzodiazepines?
When metabolized by the liver, it can switch from one benzodiazepine to another, so it can have different durations of action.
If a person takes a benzodiazepine but wants to reverse the effects, what drug would they take?
Flumazenil.
Benzodiazepine antagonist
Describe resistance to benzodiazepines.
Reduces effectiveness due to reduced sensitivity. Does not increase elimination.
Describe resistance to barbituates.
Reduced effectiveness due to reduced sensitivity and more rapid elimination.
A person is taking a benzodiazepine but uses alcohol and barbiturate for a long period of time, what might occur?
Build resistance and cause decreased sensitivity and form a cross-tolerance
A patient has cataract surgery the following day and has been drinking alcohol frequently, would you need to increase or decrease the prescription given of benzodiazepine for the surgery? Why?
You would need to increase the dose because alcohol builds the resistance of benzodiazepines due to cross resisitance.
What drug class develops dependence and would need to be tapered off in order to not have withdrawals?
Benzodiazepines
If a person was taking a benzodiazepine during surgery, would they feel pain?
Yes, they would still feel pain but they might not remember it.
What drug class is used as an additive for anesthetics?
Benzodiazipenes
When is the only time barbituates are used?
During surgery
Compare barbituates to benzodiazepines.
Barbituates have the same mechanism of action and have the same use. However, barbituates can cause anesthesia, coma, or death. It is also harder to reverse if overdosed than benzodiazepines.
What has a higher chance of abuse and is more dangerous? Benzodiazepines or barbituates?
barbituates are more dangerous and has higher chance of abuse.
What has a higher chance of abuse and is more dangerous? Benzodiazepines or barbituates?
barbituates are more dangerous and has higher chance of abuse.
Do barbituates also have an antagonist drug like flumazenil that reverses the action of the drug?
No, it is not able to be reversed by an antagonist.
What side effect can be seen when giving a barbiturate through IV?
Hypotension
If a patient is ONLY suffering from a sleeping disorder like insomnia, what would be the best drug class to prescribe? Why?
Benzo-like drugs would be the best to prescribe because they are less likely to produce dependence or tolerance.
Zolpidem, Zalephon, Eszopiclone
If a patient is ONLY suffering from a sleeping disorder like insomnia, what would be the best drug class to prescribe? Why?
Benzo-like drugs would be the best to prescribe because they are less likely to produce dependence or tolerance.
Zolpidem, Zalephon, Eszopiclone
What drug is a melatonin agonist and can also help with sleep?
Ramelteon
What drug is ONLY used to treat anxiety?
buspirone
How must buspirone be taken?
Must be taken chronically because it has a delayed onset of about a week after the first dose. It is used to anticipate an anxiety attack and NOT used for sudden anxiety attacks.
What drug is a serotonin receptor agonist?
Buspirone
What drug classes are used for acute anxiety attacks?
Benxodiazepines and barbiturates.
What medications are best for pre-anesthetic?
Lorazepam, midazolam, diazepam
What medication is best for outpatient surgery?
Midazolam
What medication is best for inpatient surgery?
Thiopental
Most common medication for muscle spasms
Diazepam
What anxiolytic drug class can be used to treat alcohol or opiate physical dependence/ addiction? How?
Benzodiazepines.
Sedates the patient heavily for a few days to lessen the withdrawal effects.
What drug is a long-acting opiate antagonist and used with psychotherapy support to treat alcohol dependence?
Naltrexone
A patient is recovering from alcoholism. Whenever this patient drinks alcohol, it is very unpleasant and they get unwanted symptoms. What drug might they be taking?
Disulfiram
Common drugs that are used to treat epilepsy
Phenobarbital
Clonazepam
Diazepam
Common drugs that are used to treat insomnia
Triazolam
Eszopiclone
Zolpidem
