Ch 34 Sedatives - Hypnotics

Question 1

Drugs used to treat anxiety disorders are called __.

Answer 1

antianxiety agents, anxiolytics, or tranquilizers

Question 2

Drugs that promote sleep are called __.

Answer 2

hypnotics

Question 3

Barbiturates and other general CNS depressants are undesirable in that they can cause (4).

Answer 3

fatal respiratory depression,
have a high potential for abuse,
cause significant tolerance and physical dependence,
and often induce hepatic drug metabolizing enzymes

Question 4

__ are preferred to barbiturates and other
general CNS depressants because they are much safer, have a low abuse potential, cause less tolerance and dependence, and don’t induce drug-metabolizing enzymes.

Answer 4

Benzodiazepines

Question 5

Although benzodiazepines can cause physical dependence, the withdrawal syndrome is usually __.

Answer 5

mild

except in patients who have undergone prolonged high-dose therapy

Question 6

To minimize withdrawal symptoms, benzodiazepines should be discontinued ___.

Answer 6

gradually, over several weeks or even months.

Question 7

___ cause minimal respiratory depression when used alone, but can cause profound respiratory depression when combined with other CNS depressants (e.g., opioids, alcohol).

Answer 7

Benzodiazepines

Question 8

Benzodiazepines produce their effects by enhancing the actions of __.

Answer 8

GABA, the principal inhibitory neurotransmitter in the CNS.

Question 9

Although benzodiazepines undergo extensive metabolism, in most cases the metabolites are pharmacologically active. As a result, responses produced by administering a particular benzodiazepine often persist __.

Answer 9

long after the parent drug has disappeared from the blood.

Question 10

All of the benzodiazepines have essentially equivalent
pharmacologic actions; hence, selection among them is
based in large part on differences in ___.

Answer 10

time course

Question 11

The principal indications for benzodiazepines are (3).

Answer 11

anxiety, insomnia, and seizure disorders

Question 12

The principal adverse effects of benzodiazepines are (2).

Answer 12

daytime sedation and anterograde amnesia

Question 13

Rarely, patients taking benzodiazepines to promote sleep

carry out sleep ___.

Answer 13

driving and other complex behaviors, and

then have no memory of their actions

Question 14

__, can be used to treat benzodiazepine overdose.

Answer 14

Flumazenil, a benzodiazepine receptor antagonist

Question 15

Like the benzodiazepines, the ___ , produce their effects by enhancing the
actions of GABA.

Answer 15

benzodiazepine-like drugs—zaleplon [Sonata], eszopiclone [Lunesta], and zolpidem [Ambien, others]

Question 16

When insomnia has a treatable cause (e.g., pain, depression, schizophrenia), primary therapy should be directed at the underlying illness; hypnotics should be used ___.

Answer 16

only as adjuncts

Question 17

__ is highly effective for insomnia, and hence is considered first-line treatment, even if drugs are also employed.

Answer 17

Cognitive behavioral therapy

Question 18

(2) are drugs of choice for insomnia.

Answer 18

Benzodiazepines and the benzodiazepine-like drugs

zolpidem, zaleplon, eszopiclone

Question 19

When benzodiazepines are used for transient insomnia,

treatment should last only __.

Answer 19

2 to 3 weeks