intro to drugs of abuse sedative hypnotics alcohol (kruse)

Question 1

how are benzos metabolized

Answer 1

CYP3A4 phase I and glucuronidation phase II

hepatically

Question 2

benzos which has the fastes onset of action

second most

Answer 2

diazepam, can die VERY fast

alprazolam, ski down the swiss alps FAST

Question 3

which benzo has slowest onset

Answer 3

oxazepam

slow as an ox

Question 4

which benzos have intermediate onset of action

Answer 4

lorazepam and clonazepam

LCs bbq is intermediate when comes to best kc bbq

Question 5

which benzo has the longest half life

Answer 5

diazepam

Question 6

which benzo has the shortest half life and is good alternative to succinylcholine before surgery as an anesthetic

Answer 6

midazolam

Question 7

which benzo has an active metabolite

Answer 7

diazepam

Question 8

intermediate to long acting benzos

Answer 8

DLC

diazepam, lorazepam clonazepam

Question 9

short to intermediate acting benzos

Answer 9

MOATT

midazolam, oxazepam, alprazolam, triazolam, temazepam

Question 10

if you have an addict should you give a benzo with slow or fast onset

Answer 10

slow

Question 11

moa of newer hypnotics and examples

Answer 11

bind GABA alpha receptor that contain a1 subunit
only approved for sleep disorders
eszopiclone, zolpidem, zaleplon

Question 12

antagonist for benzo overdose

Answer 12

flumazenil

how did i get over being sick of driving the benzo for too long?

i flew in the maz

Question 13

zolpidem, zaleplon, eszopiclone benefits

which is biphasic
which act rapidly
which has longest half life

Answer 13

rapid onset, minimal hangover efefcts

zolpidem is biphasic
zolpidem and zaleplon act rapidly
eszopiclone has longer half life

Question 14

ramelteon use and moa

Answer 14

treatment of insomnia
caRAMEL tea puts you to sleep
MELT for melatonin MT1 and MT2

Question 15

ramelteon is metabolized by what and avoid admin with what

Answer 15

CYP1A2
avoid coadministration with fluvoxamine

camels and flying oxes dont mix

Question 16

AE ramelteon

Answer 16

decrease in testosterone and increase prolactin

think girly men drink caramel tea

Question 17

buspirone use, onset of effect, AEs, metab

Answer 17

GAD
takes a week to work
no sedation, euphoria, anticonvulsant, or muscle relaxant

metab by CYP3A4

Question 18

what kind of kinetics does alcohol follow

Answer 18

ethanol metab follows 0 order kinetics so enzymes are almost immediately saturated

Question 19

alcohol inhibits what

Answer 19

the ability of glutamate to open the cation channel of the NMDA receptor which leads to increased depression of CNS

Question 20

treatment of acute withdrawal syndrome for alcohol

Answer 20

benzos

Question 21

primary treatment for alcohol dependence

Answer 21

psychosocial therapy

Question 22

naltrexone is approved for

Answer 22

treatment of alcohol and opiate dependence
u opiod receptor antagonist and long acting

individuals must be opiod free before initiating therapy

Question 23

acamprostate moa and use

Answer 23

weak NMDA receptor antagonist and GABAa receptor agonist
reduces short term and long term relapse rates

alcohol dependence drug