CNSDepressants

Question 1

CNS depressants have __ effect (2)

Answer 1

sedative

hypnotic

Question 2

CNS depressants are __ dependent

Answer 2

dose

Question 3

CNS depressants are unique in that they augment __

and/or

inhibit __

Answer 3

GABA inhibition

glutamate excitation

Question 4

sedative drugs are useful for

Answer 4

anxiety d.o

Question 5

hypnotic drugs are useful for

Answer 5

onset and maintenance of sleep → insomnia

Question 6

GABA binds to receptor and opens __ channels,

which cause __

Answer 6

Cl

decreased excitability

Question 7

3 CNS depressants to know

Answer 7

benzos

barbituates

ethanol

Question 8

which CNS depressant binds to alpha subunit receptors and requires presence of GABA for effect

Answer 8

benzos

Question 9

which CNS depressant binds directly to Cl channel at high doses and does not require GABA

Answer 9

barbituates

Question 10

at low doses, barbituates have similar action to

Answer 10

benzos

Question 11

ethanol has similar action to

Answer 11

barbituates

Question 12

z drugs (sleep drugs) bind to the same site as

Answer 12

benzos (alpha subunit)

Question 13

what drug is an antagonist to z drugs and is used in the tx of benzo toxicity

Answer 13

flumazenil

Question 14

is flumazenil effective for BARB and ethanol toxicity

Answer 14

no

Question 15

uses of benzos

Answer 15

anxiolysis → sedation

anticonvulsant

muscle relaxation

hypnosis

anesthesia

Question 16

what 2 drugs inhibit sz activity in cortical neurons at higher doses

Answer 16

benzos

barbituates

Question 17

drug of choice for status epilepticus

Answer 17

benzo → diazepam

Question 18

all benzos act as __ drugs

Answer 18

hypnosis → sleep

Question 19

__ are used to induce anesthesia

and benzos are used as __ in anesthesia

Answer 19

barbituates

adjuncts (amnesia-like)

Question 20

are benzos capable of anesthesia induction

Answer 20

no!

Question 21

what barbituate is used for anesthesia induction

Answer 21

thiopental

Question 22

bad s.e of benzos

Answer 22

tolerance

psychological dependence

withdrawal

Question 23

physical dependence is really only a concern w. __ benzo use

Answer 23

chronic

Question 24

sx of benzo withdrawal

Answer 24

nausea

fatigue

tachycardia

insomnia

dpn

wt loss

Question 25

s.e of benzos w. short half lives, benzos, and etoh

Answer 25

increased excitability → anxiety tremors hyperreflexia convulsions

Question 26

most rapid benzos

Answer 26

diazepam alprazolam clorazepate triazolam

Question 27

IM benzo

Answer 27

lorazepam

Question 28

benzo w. poor IM bioavailability

Answer 28

diazepam

Question 29

distribution of benzos is \_\_ and can terminate CNS effects of single dose

Answer 29

rapid

Question 30

benzos that cause daytime sedation dt longer half lives

Answer 30

diazepam chlordiazepoxide flurazepam

Question 31

benzos w. rapid conjugation and short lived effects

Answer 31

alprazolam triazolam

Question 32

which 2 benzos are metabolized directly to inactive glucoronides

Answer 32

lorazepam oxazepam

Question 33

which 2 benzos are good for elderly and impaired hepatic fxn dt shorter half lives and less residual effects

Answer 33

lorazepam oxazepam

Question 34

\_\_ is a major factor in benzo metabolism (2)

Answer 34

age hepatic fxn *esp phase I rxns*

Question 35

why do barbituates have declining use

Answer 35

potent CYP450 inducers many ddi

Question 36

do benzos induce CYP450 enzymes

Answer 36

no

Question 37

change in Cp is possible when benzos are given w,

Answer 37

cyp450 inducers → barbituates

Question 38

mc adr related to benzos

Answer 38

CNS dpn → daytime sedation performance impairment rebound insomnia

Question 39

adr of benzos are mc w.

Answer 39

higher doses longer half lives

Question 40

CNS are more likely in

Answer 40

older pt's

Question 41

what causes rebound insomnia

Answer 41

abrupt termination of benzos

Question 42

two drugs w. additive CNS dpn effects when mixed w. benzos

Answer 42

etoh opioid analgesics

Question 43

anterograde amnesia is common w. drugs that

Answer 43

enhance GABA neuronal fxn → depress glutamate

Question 44

beneficial use of anterograde amnesia

Answer 44

uncomfortable procedures

Question 45

criminal use of anterograde amnesia effect

Answer 45

date rape drug → flunitrazepam (rohypnol)

Question 46

benzos are a class __ drug

Answer 46

IV controlled substance *risk for dependence*

Question 47

moa for flumazenil (romazicon)

Answer 47

specific benzo antagonist

Question 48

clinical use of flumazenil

Answer 48

reverses sedative effects of benzos → od tx hasten recovery following anesthesia

Question 49

is flumazenil effective for barb or etoh od

Answer 49

nope! just benzos

Question 50

major difference btw z drugs and benzos

Answer 50

z drugs only target alpha receptors