Neuropharm Anxiolytics And Hypnotics Flashcards

1
Q

Barbiturates, phenobarbituates, benzodiazepines, benzodiazepine antidote,

A

Ok

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2
Q

Zolpidem (ambien)

A

Benzodiazepine like hypnotic drug intended for short term management of insomnia in patients who have difficulty staying asleep

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3
Q

Side effects zolpidem (ambien)

A

Daytime drowsiness, angioedema, strange sleep behaviors such as sleep eating and sleepwalking.

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4
Q

Why zolpidem taken right before bedtime

A

Rapid onset

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5
Q

MOA zolpidem (ambien

A

Hypnotic

Binds to the benzodiazepine-1 receptor site of the GABA receptor-chloride channel complex acting as an agonist

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6
Q

Purpose of zolpidem

A

Lengthen sleep time and minimize awakenings.

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7
Q

Unlike other benzodiazepines, zolpidem has no ____

A

Anti anxiety, muscle relaxing, or anticonvulsant properties

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8
Q

Indications for zolpidem

A

Insomnia

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9
Q

Side effects zolpidem

A

Daytime drowsiness, bizarre sleep behaviors (careful falling asleep while driving), angioedema

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10
Q

Considerations zolpidem

A

Short term administration

Take immediately before bed

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11
Q

Triazolan (hail on)

A

Rapid onset benzodiazepine that potentiating the inhibitory effects of GABA..causing CNS depression and is indicated for treatment of insomnia

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12
Q

Side effects triazolam (hail on)

A

Anterograde amnesia, paradoxical excitement, rebound insomnia, confusion, respiratory depression, and hypotension

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13
Q

Who is triazolam (hail on) contraindicated in

A

Pregnant women

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14
Q

Triazolam is recommended for short term. Why

A

Dependency risk

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15
Q

MOA triazolam

A

Rapid onset benzodiazepine binds to GABA receptor , increasing frequency of chloride channel opening. As chloride ions enter the channels spanning across the neuronal membrane, the neuron becomes highly negative and decreases its ability to fire electrical impulses. This action enhances the inhibitory effects of GABA and causes CNS depression

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16
Q

Indications for triazolam

A

Insomnia
Promotes sleep affecting through the cortical areas of the brain.short term acute insomnia like jet lag (not for maintain sleep it is short acting, starts sleep! Not maintain)

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17
Q

Side effects triazolam

A

Rebound insomnia, respiratory depression, hypotension, paradoxical excitement, amnesia, confusion

18
Q

Contradcitions triazolam

A

Pregnant -teratogen lipid soluble and cross placenta
Causes congenital malformations in fetus and cns depression near term
Warn female patients of baby bearing age

19
Q

Consideration triazolam

A

Short term administration
Hypnotic effects can develop quick
Faster than other benzodiazepines

20
Q

Nonbenzodiazepine hypontics

A

Zolpidem (ambien), zaleplon and eszopiclone

21
Q

Indication for nonbenzodiazepine hypnotics

A

Short term treatment of insomnia

22
Q

Are nonbenzodiazepine hypnotics more or less selective than benzodiazepines

A

More as they are not indicated for chronic anziety , muscular relaxation, or seizure disorders

23
Q

MOA nonbenzodiazepine hypnotics

A

Act on BZ1 GABA subtype receptors to increase chloride conductance. They are rapidly metabolized by the liver and have a short half like of roughly 2.5 hours

24
Q

Side effects nonbenzodiazepine hypnotics

A

Ataxia, confusion

25
Q

How treat overdose of nonbenzodiazepine hypnotics

A

Flumazenil

26
Q

Indications for nonbenzodiazepine hypnotics

A

Insomnia

27
Q

MOA nonbenzodiazepine hypnotics

A

Short half life
Acts on BZ1 GABA receptor
Less dependence

28
Q

Zolpidem (ambien)

A

Commonly used drug of this class and is also known as ambien. Reduce sleep onset latency

Also zaleplon and eszopiclone

29
Q

Side effects nonbenzodiazpipine hypnotics

A

Ataxia confusion

30
Q

Buspirone

A

Generalized anxiety but often combined with SSRI to treat clinical depression

31
Q

MOA buspirone

A

5-HT1A receptor partial agonist and increases the release of dopamine and norepinephrine
Helps mediate anxiety and depressive symptoms

Bind D2 also

32
Q

Hallmark of buspirone

A

Low side effects does not cause addiction, sedation, or tolerance (unlike benzodiazepines) does not interact with alcohol to cause respiratoy depression

33
Q

Indication buspirone

A

Generalized anxiety

Also combined with SSRI therapy to. Treat clinical depression

34
Q

MOA buspirone

A

Releases dopamine and NE-blocks presynaptic mesolimbic D2 autoreceptors in lower doses and yields increased dopamine synthesis and release. Also increases firing in the locus ceruleus-an area of brain where NE cell bodies are found in high concentrations, increasing NE

Also stimulated 5-HT1A receptors -partial agonist mediates its anxiety and anti depressive effects and because this drug is partial agonist, it has a lower side effect profile

35
Q

Side effect buspirone

A

Low side effect

No alcohol interaction

36
Q

Trazodone

A

Atypical antidepressant primarily indicated for insomnia

37
Q

At high doses, trazodone is a ___

A

Antidepressant

38
Q

MOA trazodone

A

Inhibits serotonin reuptake, but also displays serotonergic receptor antagonism

39
Q

Side effects trazodone

A

Sedation and orthostatic hypotension from blockade a1

Priapism-erection lasting long time (over 4 hours)

40
Q

Indications for trazodone

A

Insomnia also depression

41
Q

MOA trazodone

A

Inhibit serotonin reuptake

Alpha blocker

42
Q

Side effects trazodone

A

Sedation, priapism (trazoBONE), orthostatic hypotension