Anxiolytics/Hypnotics

Question 1

Benzodiazepine mechanism

Answer 1

• GABA receptor agonist
• Cl- channel opened on presynaptic neuron
• Cl- floods in hyperpolarizing cell
• > excitation is prevented

Question 2

Benzodiazepine qualities

Answer 2

• bind to GABA receptors in thalamus
• lipophilic (cross BBB)
• rapidly absorbed
• renal excretion

Question 3

Diazepam

Answer 3

• Amnestic
• uses: anxiety, muscle disorders, seizures
• CV effects: SVR maintained, decreased cerebral O2 consumption

Question 4

Versed

Answer 4

• general anesthetic
• depresses all levels of CNS
• use: short-term anxiety relief
• CV effects: hypotension, bradycardia, reduced SVR

Question 5

Flumazenil

Answer 5

• benzodiazepine antagonist
• competitive GABA inhibitor
• reverses long acting benzodiazepines

Question 6

Barbiturate

Answer 6

• depress CNS - mild sedation to coma
• no analgesic properties
• respiratory depression - decreased response to CO2
• CV effects: peripheral vasodilation, negative inotropy

Question 7

Sodium thiopental

Answer 7

• barbiturate
• short acting anesthesia induction (10-30 min)
• not used anymore

Question 8

Propofol

Answer 8

-general anesthetic/seditive (non-barb/benzo/opioid)
-uses: ICU sedation/mechanical ventilation
-CV effects: hypotension
-pharmacokinetics:
lipid soluble
30-45 second onset
1 - 2.5 mg/kg for anesthesia
50 - 200 ug/kg/min for maintenance