module 3 sedatives and hypnotics

Question 1

sedative

Answer 1

drug that produces a relaxing, calming effect

Question 2

hypnotic

Answer 2

drug used to produce drowsiness and facilitate onset of sleep

Question 3

GABA

Answer 3

inhibitory neurotransmitter in CNS

• binds to GABA receptors and opens Cl channel
• Cl enters the cell -> negative change in transmembrane potential -> hyperpolarization -> shutting down AP

Question 4

sedative-hypnotic classes

Answer 4

benzodiazepines
barbituates
misc.

Question 5

benzodiazepines MOA

Answer 5

GABA receptor modulator

• inc. activity of GABA (gabaergic effect)
• have no effect if GABA is not also present

Question 6

benzodiazepine uses

Answer 6

anxiety
panic disorders
alcohol withdrawal 
CINV
seizure prevention/termination
status epiepticus
hypnotic

Question 7

benzodiazepine AE

Answer 7

CNS depression
- less likely when used alone
tolerance
dependence

Question 8

benzodiazepine administration

Answer 8

most are active drugs -> active metabolites

exceptions:
- lorazepam
- oxazepam
- temazepam

Question 9

benzodiazepine interactions

Answer 9

CNS depressants

-> fatal CNS depression

Question 10

benzodiazepine antidote

Answer 10

flumazenil

Question 11

flumazenil MOA

Answer 11

GABA Rc antagonist

• no effect on barbiturates or alcohol
• can precipitate withdrawal

Question 12

barbiturates MOA

Answer 12

binds to GABA Rc at allosteric site
- inc. GABA activity
higher dose -> direct agonizing of Rc -> inc. CNS depression

Question 13

barbiturates use

Answer 13

anesthesia
emergency seizure tx
status epilepticus
insomnia

Question 14

barbiturates AE

Answer 14

tolerance
dependence
fatal CNS depression

Question 15

barbiturates withdrawal s/s

Answer 15

tremor
anxiety
insomnia
CNS excitability
seizure
cardiac arrest

Question 16

barbiturates interactions

Answer 16

CYP450

- 3A4 inducer

Question 17

NBRA MOA

Answer 17

bind to same site on GABA Rc as benzos but chemically different

Question 18

NBRA uses

Answer 18

hypnotic

sleep aid

Question 19

NBRA AE

Answer 19

tolerance
dependence
memory impairment/amnesia
impaired judgement/reasoning
sleep walking

Question 20

NBRA administration

Answer 20

shorter half life than benzos

eszopiclone: for chronic use

Question 21

NBRA antidote

Answer 21

flumazenil

Question 22

NBRA education

Answer 22

less time to fall asleep

less REM sleep

Question 23

remelteon MOA

Answer 23

full agonist at melatonin Rc

Question 24

remelteon use

Answer 24

sleep

- maintain circadian rhythm of sleep/wake cycle

Question 25

remelteon education

Answer 25

no tolerance or dependence

not a controlled substance

Question 26

suvorexant MOA

Answer 26

orexin Rc antagonist

- suppresses the wake drive

Question 27

suvorexant AE

Answer 27

narcolepsy

cataplexy