Anxiolytics n Hypnotics Flashcards
Why are hypnotics used?
Induce calm before surgery, during a life crisis or to supplement pain control.
What are the 4 stages of NREM sleep?
N1 - light, N2 - asleep, N3 - best sleep - muscles relaxed, energy restored, BP and RR decreased, N4 - delta wave.
What stage of NREM is considered the best sleep?
N3
What percentage of total sleep is NREM?
75%
How is the comparative amounts of NREM vs REM different when sleep is drug induced?
Increased NREM, decreased REM
In which type of sleep do we dream?
REM
Benzodiazepines - short/long term?
short - highly addictive
Which Benz should be given for early morning wakening?
Nitrazepam
Which Benz should be given for initial insomnia?
Temazepam
Negative effect of benzodiazepines?
Highly addictive, resp depression, additive effect - other CNS depressants.
How to give a Benzo and what Benzo as anticonvulsant?
IV Diaz or buccal/nasal midazolam
What 2 systems do Benzos have action on?
Limbic - controls emotion - anxiolytic effect. Reticular activating system - controls conscious alert state (hypnotic effect).
What is the general mech of action of Benzos?
Influence GABA at Cl channel/ Increase frequency of channel opening.
Agonist to benzodiazepines?
Flumazenil - induces seizures in epilepsy - administer Benzos carefully (IV) to reduce need for this.
which antihistamine is used in children?
Promethazine
What are 2 examples of Z drugs?
Zolpidem and Zopiclone - less addictive than benzos so more widely used
Examples of hypnotics?
Chlormethizaole, choral hydrate, alcohol, melatonin
Examples of anxiolytics?
Alcohol, BZD, buspirone, beta-adrenergic blockers
what drug is given to alcohol withdrawal patients?
Chlordiazepoxide
What is buspirone mech of action? when would u give it?
Serotonin receptor agonist - dry mouth, no sedation, no withdrawal effects. someone needs short term anxiety help for single situ.
is someone was having masseteric spasms? What would u prescribe and in what amount?
BZD - 2mg TDS (max)
are BZD, hypnotic, anxiolytic or both?
both
antihistamine example?
H1 blocker
Which 2 BZD can dentists prescribe?
Temazepam and diazepam, can also use the agonist flumazenil.
What to do if a patient has dry mouth?
Write to doctor and say pt has dry mouth and tell them drug which is causing, ask for drug to be changed.
