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Pharm 323 - Royce > hypnotics, sedatives, anxiolytics > Flashcards

hypnotics, sedatives, anxiolytics Flashcards

1
Q

sedatives are used for which 2 disorders?

A
  1. insomnia

2. anxiety

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2
Q

overall MOA of sedatives

A

depress CNS function

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3
Q

what agents are used for anxiety relief?

A

anxiolytics

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4
Q

what agents are used to promote sleep?

A

hypnotics

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5
Q

describe the difference in dosing between hypnotics and anxiolytics

A

SMALL doses for ANXIETY relief

LARGE doses for SLEEP induction

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6
Q

what is the drug class of choice for hypnotics (promoting sleep)?

A

benzos

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7
Q

what is the drug class of choice for both anxiety and insomnia?

A

benzos

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8
Q

what are benzos ending in? (how can we recognize/identify them?)

A

“____zepam”

OR

“____zolam”

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9
Q

MOA of benzos (3)

A
  1. depress neuron fxn
  2. decrease anxiety (through limbic system)
  3. potentiate effects of GABA
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10
Q

what is the unique aspect to GABA + benzos?

A

benzos only work on endogenous GABA; there’s a finite amount which creates a “built in” limit to CNS depression

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11
Q

what is the prototype for benzos for SLEEP

A

triazolam

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12
Q

what effects on sleep will you see with triazolam? (3)

A
  1. decreased sleep onset
  2. fewer awakenings
  3. greater amt of total sleep time
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13
Q

what are the prototypes (3) for benzos as anxiolytics?

A
  1. lorazepam (Ativan)
  2. diazepam (Valium)
  3. alprazolam (Xanax)

“that LAD is very chill… he’s not anxious at all”

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14
Q

what is the benzo commonly used for procedures?

A

midazolam (Versed)

“this benzo puts the MIDAs touch on things to chill people out before procedures”

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15
Q

what schedule drug are benzos?

A

schedule 4

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16
Q

AE (3) of benzos

just the overall category of systems they affect

A
  1. CNS
  2. Cardiovascular
  3. Respiratory
17
Q

re: SE of benzos, what’s happening with the CNS? (6)

A
  1. sedation
  2. psychomotor slowing
  3. confusion
  4. amnesia
  5. drowsiness
  6. sleep driving
18
Q

out of the CNS effects r/t benzos, what 2 will improve after ~ 1 week of starting the drug?

A

sedation + psychomotor slowing

19
Q

re: SE/AE of benzos, what’s happening with the cardiovascular system?

(PO admin + IV admin)

A

oral: little to no effect

IV: profound HYPOtension + cardiac arrest

give slow + through port closest to IV

20
Q

re: SE/AE of benzos, what’s happening with the respiratory system?

(PO admin + IV admin)

A

oral: little to no effect

IV or combine w/other CNS depressants: significant respiratory depression

21
Q

can we use benzos with preggos?

A

NOOOOO

22
Q

what type of dosing with benzos will you often see withdrawal effects with? and what s+s would you see?

A

HIGH doses

panic, paranoia, delirium, HTN, muscle twitches, convulsions

think of HTN as a rebound HTN

23
Q

how should people come off benzos?

A

slowlyyyyyy wean

24
Q

what is the antidote for benzodiazepines? and what’s the unique thing about this antidote? how often should you administer it?

A

flumazenil

  • only reverses SEDATION, not respiratory effects… but could have an indirect effect on respiratory*
  • admin: q minute over 15 mins*
25
Q

benzodiazepine-like drugs are used for what?

A

insomnia

26
Q

benzodiazepine-like drugs ALL have a risk for what?

A

sleep-driving

rare!

27
Q

what’s the prototype for benzodiazepine-like drugs (for insomnia)?

A

zolpidem (Ambien)

28
Q

what’s the indication for zolpidem?

A

SHORT TERM management of insomnia

29
Q

what are the 2 most common SE of zolpidem

A

daytime drowsiness + dizziness

30
Q

what schedule drug is zolpidem?

A

schedule 4

31
Q

what is our benzo prototype for anxiolytics?

A

diazepam (valium)

val the housewife needs her anti anxiety med

32
Q

what are our 2 non-benzo/non-barbituate prototype for anxiolytics?

A
  1. busiprone

2. hydroxyzine (scheduled QID = anxiety / prn = insomnia)

33
Q

buspirone (Buspar) is a “no” drug… what are the no’s?

A 
NOT a CNS depressant
NO abuse potential
NO suicide risk 
NO increased CNS effects with other CNS drugs 
NOT for PRN use
NO grapefruit
34
Q

what’s the drug-food interaction with buspirone?

A

grapefruit!!

35
Q

what drug class is hydroxyzine?

A

antihistamine (also affects serotonin)

36
Q

hydroxyzine scheduled QID would be for what?

A

anxiety

37
Q

hydroxyzine as PRN drug would be for what?

A

insomnia

38
Q

SE of hydroxyzine

A
  • dry mouth
  • constipation
  • HA
  • dizziness
  • fatigue

(anticholinergic SE)

39
Q

what’s an AE of hydroxyzine with LONG TERM use?

A

prolonged QT intervals (watch for dysrhythmias)

Pharm 323 - Royce (28 decks)

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