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Pharmocology > Chapter 11 > Flashcards

Chapter 11 Flashcards

1
Q

What are some anti-anxiety agents?

A
  • Benzodiazepines
  • Barbiturates
  • Sedative-hypnotics
  • Benzodiazepine receptor agonists
  • Centrally acting muscle relaxants
  • Miscellaneous agents
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2
Q

What are the values of relaxation?

A
  • more productive dental appointment
  • patient benefits
  • dental team benefits
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3
Q

What percent of americans seek oral health care only when absolutely?

A

20%

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4
Q

What percent of people refuse to seek any care because they are afraid?

A

7%

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5
Q

It is important to look for what when treating a patient?

A

indications of fear or apprehension

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6
Q

What are the most commonly prescribed anti-anxiety drugs?

A

Benzodiazepines

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7
Q

What is the onset of action related to with Benzodiazepines?

A

lipid solubility

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8
Q

How are Benzodiazepines available?

A

tablets, capsules, oral solution, rectal gel, and injectable form

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9
Q

TRUE OR FALSE: Benzodiazepines cross the blood-brain and placental barriers to produce an effect on the CNS and the fetus

A

true

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10
Q

Where are benzodiazepines metabolized?

A

liver

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11
Q

Storage in ______ tissue prolongs the action of lipid-soluble benzodiazepines.

A

adipose

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12
Q

Benzodiazepines act as what?

A

agonists at the receptor site and thereby reduce the symptoms of anxiety

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13
Q

Benzodiazepines enhance the effect of what?

A

gamma-aminobutyric acid (GABA)

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14
Q

What is GABA

A

a major inhibitory neurotransmitter in the brain

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15
Q

GABA quiets the nerve endings and plays a role in what?

A

muscle tone

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16
Q

What are the pharmacologic effects of Benzodiazepines?

A
  • behavioral effects
  • anti seizure effects
  • muscle relaxation
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17
Q

What two drugs have anti-seizure effects?

A

Diazepam

Clonazepam

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18
Q

Repeated doses of benzodiazepines can lead to what?

A

a reduction in stages 3 and 4 sleep causing a reduction in restorative sleep

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19
Q

Low doses of benzodiazepines cause what?

A

anxiety and panic reduction

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20
Q

High doses of benzodiazepines cause what?

A

drowsiness or sleep

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21
Q

what are the adverse reactions of Benzodiazepines?

A
  • anterograde amnesia
  • respiratory effects
  • cardivascular effects
  • visual effects
  • dental effects
  • thrombophlebitis
  • Gi tract
  • genitourinary tract
  • allergies
  • pregnancy/lactation
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22
Q

What are the pregnancy and lactation considerations for Benzodiazepines?

A
  • increased risk of congenital malformations

- floppy infant syndrome

23
Q

Can benzodiazepines be abused?

A

YES HUNNY

24
Q

TRUE OR FALSE: Physical dependence and tolerance have been documented for benzodiazepines

A

true

25
Q

Combining benzodiazepines mixed with alcohol can result in what?

A
  • coma
  • respiratory depression
  • hypotension
  • hypothermia
26
Q

Benzodiazepines: Drug interactions

A
  • Additive effect with other CNS depressants

- Smoking reduces their effectiveness

27
Q

What drugs may increase the effects of benzodiazepines?

A

Cimetidine (Tagamet)
Omeprazole ( Prilosec )
* they also can increase the effect of digoxin and phenytoin

28
Q

What are Benzodiazepines medical uses?

A
  • insomnia
  • acute seizures
  • alcoholism
  • muscle spasms
  • anxiety
  • panic attacked
  • cautious sedation, general anesthesia
29
Q

Benzodiazepines: Dental relevance

A
  • avoid additive CNS depression
  • Avoid addicts and prego women
  • Document accurately in pt record
  • Use with caution with elderly and pt taking Tagamet
  • warn pt about sedation and amnesia
  • match onset/duration
  • provide postoperative instruction
  • monitor vitals
30
Q

The original sedative-hypnotic and have almost completely been replaced by benzodiazepines for treating anxiety and insomnia bc of the wider TI

A

barbiturates

31
Q

Barbiturates are still used as what?

A

anticonvulsants and to induce general anesthesia

32
Q

Where are barbiturates well absorbed?

A

orally and rectally

33
Q

What solutions are irritating with barbiturates?

A

injectables

34
Q

Rapidly and almost completely metabolized by the liver

A

short and intermediate acting barbiturates

35
Q

largely excreted through the kidneys

A

long acting barbiturates

36
Q

what do barbiturates enhance?

A

GABA receptor binding

37
Q

what do barbiturates prolong?

A

the opening of chloride channels

38
Q

What do barbiturates act directly on?

A

chloride channels

39
Q

Barbiturates mechanism of action is less specific than what?

A

benzodiazepines

40
Q

what are the pharmacologic effects of barbiturates?

A
  • CNS depression
  • No analgesia effect
  • anticonvulsant effect
41
Q

What are the adverse reactions of barbiturates?

A
  • stimulation
  • fetal harm
  • can lethal
  • coughing
  • depress liver/kidney function
  • lower body temo
  • acute poisoning
  • reduce GI motility
42
Q

What happens if you take barbiturates for a chronic ling term?

A
  • physical/psychological dependence
  • tolerance develops except to lethal dose
  • cross tolerance occurs
43
Q

Barbiturates can stimulate and increase what?

A

the synthesis of porphyrins, which are already at the excessive level in this dsisease

44
Q

What are the contraindications of barbiturates?

A

Pt’s with intermittent porphyria or a positive history of porphyria

45
Q

a genetic metabolic disorder affecting the production of heme, the oxygen-binding prostheitc group of hemoglobin

A

porphyria

46
Q

What are the uses for ultrashort acting barbiturates?

A

used in IV for induction of general anesthesia

47
Q

What are the uses for short and intermediate acting barbiturates?

A

little medical uses; replaced by benzodiazepines

48
Q

What are the uses for long acting barbiturateS?

A

used for treatment of epilepsy

49
Q

Receptor agonists

A
  • used to treat insomnia
  • Zolpidem (ambian)
  • Zaleplon (sonata)
  • Eszopiclone (lunesta)
50
Q

What are some centrally acting muscle relaxants?

A

Carisoprodol ( Soma )

Cyclobezanprine ( Flexeril)

51
Q

Where do centrally acting muscle relaxants exert their effects?

A

on the CNS to produce muscle relaxation

52
Q
  • Indicated for spasticity from multiple sclerosis or spinal cord injuries or diseases
  • Treats trigeminal neuralgia
A

Baclofen (Lioresal)

53
Q

Tizanidine (Zanaflex)

A

muscle relaxant

54
Q
  • Treatment of spasticity from upper motor neuron disorders

- Prevent and treat malignant hyperthermia

A

Dantrolene (Dantrium)

Pharmocology (12 decks)

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