EXAM #3: REVIEW Flashcards
What sedative drug classes are “selective” CNS depressants?
1) Barbiturates
2) Benzodiazepines
3) Ethanol
Outline the progression of dose-dependent effects seen with the sedative hypnotics.
1) Sedation
2) Sleepiness
3) Anesthesia
4) Coma
5) Respiratory depression/ death
List the six clinical indications for the sedative hypnotics.
1) Anxiety
2) Insomnia
3) Amnesia-induction
4) Seizures
5) Ethanol withdrawal
6) Muscle relaxation
What are the two suffixes associated with the Benzodiazepines?
- “zepam”
- “zolam”
What are the two benzodiazepines that undergo metabolism to weakly active, short lived metabolites with intermediate duration of action?
- Alprazolam
- Triazolam
What effects are associated with Alpha-1 GABA receptor agnoism?
1) Sedation
2) Anticonvulsant
3) Anterograde amnesia
What effect is associated with Alpha 2,3, and 5 GABA receptor agonism?
Anxiolysis
What are the five adverse effects associated with benzodiazepines?
1) Respiratory depression
2) Anterograde amnesia
3) Tolerance
4) Dependence
5) Withdrawal
What drug classes will cause additive CNS depression when combined with benzodiazepines?
1) Ethanol
2) Opoids
3) Anticonvulsants
4) Phenothiazine
5) Antihistamines
6) TCAs
List the four indications for Barbiturates.
1) Anticonvulsant
2) Sedative-hypnotic
3) Anesthesia
4) Medically induced coma
List the three common side effects of the MAOIs.
- Orthostatic hypotension
- Weight gain
- Sexual dysfunction
What are TCAs first line therapeutic agents for?
Chronic pain
What are TCAs second line therapeutic agents for?
Major depression
What TCA is used to treat neuropathic pain?
Desipramine
What TCA has the most sedative effects?
Amitriptytline
What is the MAJOR side effect to remember as being associated with the TCAs?
Cardiac toxicity i.e. induction of lethal cardiac arrhythmias
What are all of the side effects of the TCAs?
1) Cardiac toxicity
2) Orthostatic hypotension
3) Delirium in the elderly
4) Sexual dysfunction
What is important to remember about the safety of SSRIs compared to other antidepressants?
SSRIs are much safer than MAOIs or TCAs
What symptoms compose the triad of Serotonin Syndrome?
1) AMS
2) Autonomic hyperactivity
3) Neuromuscular abnormalities
What is the MOA of Venlafaxine?
SNRI
What receptor does Venlafaxine have its major effect on? Minor?
Major= SERT Minor= NET
What is the clinical indication for Venlafaxine?
Severe Depression
What is the MOA of Duloxetine?
SNRI with balance SERT and NET inhibition
What is the primary clinical indication for Duloxetine?
Chronic pain (increasingly prescribed over the TCAs i.e. Desipramine)