CNS 2: Sedative-hypnotic, antianxiety, Alzheimer's

Question 1

3 classes of drugs used for sedative-hypnotic and anti-anxiety drugs

Answer 1

benzodiazepines
non-benzodiazepines
atypical anti-anxiety drugs

Question 2

Sedative-hypnotic benzodiazepines

Answer 2

temazepam
triazolam
estazolam
quazepam

Question 3

Anti-anxiety benzodiazepines

Answer 3

diazepam
lorazepam
alprazolam

Question 4

Benzodiazepines MOA

Answer 4

increase frequency of Cl- ion channel opening

Enhance GABA inhibition on GABA A; decrease anxiety

Question 5

Pharmacological effects of benzodiazepines (6)

Answer 5

-reduction of anxiety and aggression
-induction of sleep
-anterograde amnesia
-anticonvulsant effect
-reduction of mus tone and coordination
-effects of respiration and on CVS

Question 6

Adverse effects of benzodiazepines (6)

Answer 6

-excessive sedation (hungover)
-motor impairment
-confusion in elderly
-discontinuation syndrome (rebound insomnia)
-potentiates CNS depressant effect of ethanol
-tolerance and dependence

Question 7

Z drugs (3) and advantages

Answer 7

zolpidem, zaleplon, eszopiclone

bind to GABA receptors in brain, possible more selective
-fewer problems when discontinued (less rebound insomnia)

Question 8

Newer anxiolytic agent (?)

Atypical anxiolytic agent, MOA

Answer 8

Buspirone

Acts as a partial agonist for serotonin 5-HT1A receptors in the brain

Question 9

Common symptoms of AD for 3 stages

Answer 9

Mild: memory loss, lingual probs, mood deviations

Mod: learning probs, dementia, aggression, dependent on others for daily chores

Severe: motor impairment, bedridden

Question 10

Pathological hallmarks of AD (6)

Answer 10

-increased tau-tangles
-increased alpha beta-plaques
-increased glutamate
-increased cholesterol in neurons
-decreased acetylcholine
-cerebrovascular pathologies

Question 11

Pathophysio of AD

Answer 11

Preclinical AD → mild cognitive impairment → dementia d/t mild AD → dementia d/t AD mod → dementia d/t AD severe

Question 12

Neurotransmitter abnormalities in AD (2)

Answer 12

-decline in acetylcholine
-loss of cholinergic neuros

Question 13

Approved meds for AD (4)

Answer 13

donepezil, rivastigmine, galantamine, memantine

Question 14

Donepezil stages and AE

Answer 14

mild to severe

n/v, diarrhea, dizziness, blurred vision, bradycardia, atrioventricular block, bronchoconstriction

Question 15

Rivastigmine stages and AE

Answer 15

minimal to mod

n/v, diarrhea, dizziness, blurred vision, bradycardia, atrioventricular block, bronchoconstriction

Question 16

Galantamine stages and AE

Answer 16

mild to mod

n/v, diarrhea, dizziness, blurred vision, bradycardia, atrioventricular block, bronchoconstriction, serious skin reactions

Question 17

Memantine stages and AE

Answer 17

mod to severe

n/v, diarrhea, dizziness, blurred vision, bradycardia, atrioventricular block, bronchoconstriction

Question 18

What time range is best for anxiolytic benzodiazepines? what SE can cause backfire?

Answer 18

2-4 hours

hypnotic effects

Question 19

How can PT help Alzheimer’s? (3)

Answer 19

-physical act improves memory
-reg ex may delay onset of dementia and Alz
-reg ex may delay ADL inability