CNS drugs 1: Sedative-Hypnotics\

Question 1

major classifications under SEDATIVE-HYPNOTICS

Answer 1

BENZODIAZEPINES
BARBITURATES
MISCELLANEOUS AGENTS

Question 2

Short-action BENZODIAZEPINES

Answer 2

SHORT ACTION
Midazolam
Triazolam
Etizolam
B,O

Question 3

intermediate action benzo

Answer 3

INTERMEDIATE ACTION
Lorazepam
Alprazolam
Clonazepam
Estazolam
L,N,T

Question 4

long-acting benzo

Answer 4

LONG ACTION (s/e: dec REM sleep)
Diazepam
Flurazepam
Flunitrazepam (date-rape drug)
Chlordiazepoxide (LONGEST t 1/2: 35-200 hours)
Q,C

Question 7

classifications of BARBITURATES

Answer 7

ULTRA-SHORT ACTING
Thiopental

SHORT ACTING
Secobarbital

LONG ACTING
Phenobarbital

Question 8

Miscellaneous drugs under SEDATIVE-HYPNOTICS

Answer 8

Buspirone
Chloral hydrate
Eszopiclone
Ramelteon
Zaleplon
Zolpidem

Question 9

which is safer, benzo or barbiturates

Answer 9

benzodiazepine (with “celing effect”

Question 10

site f action of benzo and barbi

Answer 10

GABA-A

GABA-B: baclofen

Question 11

what enz is deficieent in acute intermittent porpyria

Answer 11

HMB synthase

Question 12

what is the most catastrophic symptom of sedative-hypnotic withdrawal

Answer 12

rebound suicide

Question 13

Ultra-short acting barbi

Answer 13

†thiopental
thiamylal
ªmethohexital

†thiopental used to be the induction agent of choice in anesthesia before the discovery of PROPOFOL

Question 14

intermediate-acting barbi

Answer 14

Secobarbital
Pentobarbital
B,B,A,T,A

Question 15

Long-acting barbi

Answer 15

phenobarbital
primidone
mephobarbital

Question 16

for seizure induction for epileptic px undergoing temporal lobe resection

Answer 16

methohexital

Question 17

barbi used in hyperbilirubinemia

Answer 17

long-acting (eg phenobarbital)

such as Gilbert’s syndrome

Question 18

DOC for seizures in infants

Answer 18

Phenobarbital 📌

-s/e: precipitates porphyria

Question 19

what drugs are contraindicated in porphyria

Answer 19

barbiturates, becuase they promote activity of ALA SYNTHASE, thus enhancing porphyrin synthesis

Question 20

newer hypnotic used for Generalized anxiety disorder

Answer 20

BUSPIRONE

• 5HT1A partial agonist and D2 agonist
• safe for pregnant patients

Question 21

newer hypnotic used for insomnia and sleep disorders esp when sleep onset is delayed

Answer 21

ZZZzzzz
Zolpidem
Zaleplon
Escopliclone

Question 22

melatonin receptor agonist

Answer 22

remelteon

Question 23

effect that’s very specific to benzodiazepines

Answer 23

anterograde amnesia

Question 24

MOA of flumazenil

Answer 24

competitive antagonist at GABA-A