Chapter 20-Anxiolytics/sedatives Flashcards
1
Q
When do peak plasma leves occur?
A
- after several hours
- exception: diazepam after around 1 hour
- depends on the route of administration (usually taken orally)
2
Q
What contributes to sedatives long duration?
A
they are converted into active metabolites
3
Q
Ultra short-acting usage
A
- pre-anesthesis
- intra-operatively
- status epilepticus
4
Q
short acting usage
A
- insomnia, status epillepticus
- high misuse liability
5
Q
intermediate acting usage
A
- anxiety symptoms
- alcohol detoxification
6
Q
long acting usage
A
treatment of seizure disorders
7
Q
Tolerance BZs and barbiturates
A
- slow- anxiolytic effects
- fast- sedative anticonvulsant effects
- not appear to be associated with metabolism or Pavlovian conditioning
8
Q
Cross tolerance and BZ/barbiturates
A
cross tolerance seen to other sedative drugs like alcohol
9
Q
Misuse- benzos and barbs
A
- seen in individuals w/ pattern of multiple drug misuse
- BZs used to enhance effects (ex. alc and opiates) or reduce side effects (ex. cocaine)
10
Q
ER visits and benzos
A
- mostly seen for nonmedical use
- then self harm
- then therpeutic use
- then unsupervised ingestion
11
Q
dependence and withdrawal reactions- what do these result from and how long to appear?
A
- may result from chronic use
- may not appear for a week or so
12
Q
low/moderate use withdrawal reactions
A
- anxiety
- agitation
- sensitivity to light and sound
- strange sensations
- muscle cramps and twitches
- sleep disturbances
- dizziness
13
Q
high use withdrawl reaction
A
- panic
- seizures
- delirium
14
Q
issues w bzs and barbs
A
- amnesia- seen when used for trauma and pre-exam anxiety
- confusion, agitation, and psychological disturbances- common side effects w Triazolam (Halcion)- which is prescribed for insomnia
15
Q
Reinfocing effects of BZs
A
- BZs have reinforcing effects primarily in subjects with drug/alcohol misuse, anxiety, and sleep disorders
- BZs will not typically act as a reinforcer in subjects that lack these characteristics
16
Q
Atypical Anxiolytics
A
includes buspirone, MAOIs, and SSRIs
17
Q
Buspirone
A
- not a BZ- acts on serotonin system
- is an atypical anxiolytic
- originally intended as an antipsychotic
- takes 1-2 weeks before onset
- critical for people needing daytime alertness
18
Q
Insomnia
A
- a frequent complaint: usually a manifestation of some other underlying disorder
- treating cause is more likely to produce better relief
- normal sleep is cyclic between light, deep, and REM (dreaming)
19
Q
Flurazepam (Dalmane)
A
- insomnia treatment
- less ideal
- raise arousal threshold… can detect small noises but not loud
- disrupts deep sleep states
20
Q
Short acting insomnia med
A
- temazepam, triazolam (halcion)
- induces insomnia (increased wakefulness) during final sleep hours
- can cause rebound insomnia
- used as insomnia treatment
21
Q
Zolpidem(Ambien)
A
another insomnia med
