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AU14 Pharmacology > Exam 2; Anti-Anxiety and Hypnotics > Flashcards

Exam 2; Anti-Anxiety and Hypnotics Flashcards

1
Q

What are the definitions of anxiolytics, sedatives, and hypnotics

A

anxiolytics; reduce anxiety
sedatives; induce calmness without drowsiness
hypnotics; induce normal sleep

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2
Q

True or False

anxiolytics, sedatives, and hypnotics are all derived to treat diseases

A

False; they only treat symptoms

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3
Q

Most of these drugs target what

A

GABA; the major inhibitory neuron

**activating the receptor

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4
Q

These are the major anti-anxiety drugs; the “‘-pam’s” and “-lam’s” long duration, low dose

A

benzodiazepines
+ chlorodiazepoxide
The beginning letters; D, A, C, C, O, L

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5
Q

These are used primarily for the treatment of insomnia; shorter duration, higher dose

A 
flurazepam
temazapam
estrazolam
Quazepam
triazolam
F, T, E, Q, T
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6
Q

This is used in general anesthesia; given IV

A

midazolam

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7
Q

What is the effect of a low dose of benzodiazepines

A

decrease aggressive behavior and anxiety

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8
Q

What is the effect of a high dose of benzodiazepines

A

sedation and hypnosis
anesthesia
amnesia

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9
Q

What kind of mechanisms cause muscle relaxation, involving the benzodiazepines

A

central and spinal cord mechanisms; anti-spastics

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10
Q

benzodiazepines are also used for what

A

anti-convulsant effects

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11
Q

Where are the active benzodiazepine receptor sites on the brain

A

close to or on the GABA receptor of neurons

not where GABA binds directly

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12
Q

What is the activity of benzodiazepine on its receptors

A

it enhances the effect of GABA on its receptor; makes the receptor more sensitive to GABA

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13
Q

What are the two metabolitic paths of benzodiazepines

A

absorbed from the GI if given orally

metabolized in the liver; not induce P450

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14
Q

What causes tolerance of benzodiazepines

A

down regulation of the benzodiazepine binding sites

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15
Q

What could the result be from withdrawal of benzodiazepines

A

seizures

hyperactivity of the brain due to loss of inhibitory action

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16
Q

What is habituation

A

not the same as addiction

become psychological dependent; you THINK you need it

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17
Q

What is the therapeutic index of benzodiazepines

A

very high; it is virtually impossible to kill yourself with solely these; low toxicity

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18
Q

What are five side effects of benzodiazepines

A 
drowsiness
ataxia
impaired judgment
confusion; especially in the elderly
decreased ability to learn new material
19
Q

benzodiazepines can interact with this CNS depressant

A

ethanol

20
Q

What are two visual disturbances of benzodiazepines

A

diplopia

nystagmus

21
Q

This is a benzodiazepine receptor blocker; given IV due to 1st pass metabolism

A

flumazenil

22
Q

These act by binding to α subunits of benzodiazepine receptor

A

non-benzodiazepine hypnotics

23
Q

What are three non-benzodiazepine hypnotics

A

zolpidem
zaleplon
eszopiclone
the “z” drugs

24
Q

What are four behavioral changes that can occur with non-benzodiazepine hypnotics

A

decreased inhibitions
bizarre behaviors
sleep driving
hallucinations

25
Q

This is an α2 agonist non-benzodiazepine hypnotic which induces sleep, causing sedation without respirator depression

A

Dexmedetomidine

26
Q

What are two symptoms of dexmedetomidine

A

decreased blood pressure

bradycardia

27
Q

This is an slow onset anti-anxiety non-benzodiazepine hypnotic that is a partial serotonin agonist with no sedative or hypnotic effects

A

buspirone

28
Q

These barbiturates have a 3-4 hour duration

A

pentobarbital

secobarbital

29
Q

These barbiturates have a 6-8 hour duration

A

butaberbital

amobarbital

30
Q

These barbiturates have a 10-16 hour duration

A

phenobarbital

31
Q

what is the mechanism of action behind barbiturates

A

enhance the action of GABA; much more efficient that benzodiazepines

32
Q

barbiturates act on which who places

A

reticular activating system

acts on sensory cortex leading to unconsciousness

33
Q

are barbiturates more or less potent that benzodiazepines

A

less potent; use a higher dose

34
Q

True or False

barbiturates are not analgesics

A

True

35
Q

barbiturates act on this center; which if there is an OD of barbiturates it will lead to death due to respiratory depression

A

medullary respiratory center

36
Q

What other use besides hypnosis are barbiturates used for

A

epilepsy

37
Q

What are two contraindications of barbiturates

A

decreases respiration

TI = 10; used in suicides

38
Q

What can barbiturates interact with regarding other drugs

A

ethanol

synergistic CNS depression

39
Q

What can occur when someone who is dependent on barbiturates, stops taking them

A

they suppress REM sleep, so when you stop, you have a large increase in REM leading to nightmares

40
Q

These are melatonin receptor agonists; no effect of GABAergic pathways

A

rameltheon

tasimeltheon

41
Q

rameltheon and tasimeltheon help maintain what

A

normal circadian sleep rhythms; reduces the time to fall asleep

42
Q

What are two side effects of rameltheon and tasimeltheon

A

somnolence (sleepiness)

fatigue

43
Q

What are two long term symptoms of rameltheon and tasimeltheon

A

decreased testosterone synthesis

synergistic with ethanol

44
Q

What OTC can interact with rameltheon and tasimeltheon

A

anti-histamines; drowsiness

AU14 Pharmacology (29 decks)

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