Anxiolytics n Hypnotics

Question 1

Why are hypnotics used?

Answer 1

Induce calm before surgery, during a life crisis or to supplement pain control.

Question 2

What are the 4 stages of NREM sleep?

Answer 2

N1 - light, N2 - asleep, N3 - best sleep - muscles relaxed, energy restored, BP and RR decreased, N4 - delta wave.

Question 3

What stage of NREM is considered the best sleep?

Answer 3

N3

Question 4

What percentage of total sleep is NREM?

Answer 4

75%

Question 5

How is the comparative amounts of NREM vs REM different when sleep is drug induced?

Answer 5

Increased NREM, decreased REM

Question 6

In which type of sleep do we dream?

Answer 6

REM

Question 7

Benzodiazepines - short/long term?

Answer 7

short - highly addictive

Question 8

Which Benz should be given for early morning wakening?

Answer 8

Nitrazepam

Question 9

Which Benz should be given for initial insomnia?

Answer 9

Temazepam

Question 10

Negative effect of benzodiazepines?

Answer 10

Highly addictive, resp depression, additive effect - other CNS depressants.

Question 11

How to give a Benzo and what Benzo as anticonvulsant?

Answer 11

IV Diaz or buccal/nasal midazolam

Question 12

What 2 systems do Benzos have action on?

Answer 12

Limbic - controls emotion - anxiolytic effect. Reticular activating system - controls conscious alert state (hypnotic effect).

Question 13

What is the general mech of action of Benzos?

Answer 13

Influence GABA at Cl channel/ Increase frequency of channel opening.

Question 14

Agonist to benzodiazepines?

Answer 14

Flumazenil - induces seizures in epilepsy - administer Benzos carefully (IV) to reduce need for this.

Question 15

which antihistamine is used in children?

Answer 15

Promethazine

Question 16

What are 2 examples of Z drugs?

Answer 16

Zolpidem and Zopiclone - less addictive than benzos so more widely used

Question 17

Examples of hypnotics?

Answer 17

Chlormethizaole, choral hydrate, alcohol, melatonin

Question 18

Examples of anxiolytics?

Answer 18

Alcohol, BZD, buspirone, beta-adrenergic blockers

Question 19

what drug is given to alcohol withdrawal patients?

Answer 19

Chlordiazepoxide

Question 20

What is buspirone mech of action? when would u give it?

Answer 20

Serotonin receptor agonist - dry mouth, no sedation, no withdrawal effects. someone needs short term anxiety help for single situ.

Question 21

is someone was having masseteric spasms? What would u prescribe and in what amount?

Answer 21

BZD - 2mg TDS (max)

Question 22

are BZD, hypnotic, anxiolytic or both?

Answer 22

both

Question 23

antihistamine example?

Answer 23

H1 blocker

Question 24

Which 2 BZD can dentists prescribe?

Answer 24

Temazepam and diazepam, can also use the agonist flumazenil.

Question 25

What to do if a patient has dry mouth?

Answer 25

Write to doctor and say pt has dry mouth and tell them drug which is causing, ask for drug to be changed.