Pharm II, sedatives anxiolytics Flashcards by jennifer davidson

Physical sx of anxiety

tachycardia- trembling- sweating- palpationa

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in general what do all of the anxity drugs have in common

sedative

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what were the first antianxiety drugs to be discovered

barbiturates - they all have potent side effects

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what will make anxiolytics moe sedative

adding alcohol

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what are both barbituates and benzodiazepines noted for

tolerance - phycholocigal and physical dependence

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receptors for benzos and barbs

bind adjacent to GABA receptors - which increases GABA receptors affinity to GAPA

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what does GABA binding do

prolong Chloride ion channels

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which drugs are rumored to be truth serum

barbiturates - they all have potent side effects

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barbituates effect on pain

they do not have analgesic properties - it is used pre op to calm and to induce sleep prior to anesthesia

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what are the 4 classifications of barbituates

ultra short - short- intermediated - long

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ultra short acting barb

Thipental/Penthothal

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how are ultra short acting barbs used

Thipental/Penthothal- IV - 1 minute

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short acting barb

pentobarbitol/nembutal

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how are short acting barbs used

pentobarbitol/nembutal - iv or ORAL 15-30 min onset- last 6-8 hrs

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intermediate barb

butalbital/fiorinal talking about taking off market

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how is intermediate barb used

butalbital/fiorinal - oral 20-40 min onset- lasting 6 hours

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long acting barb

phenobarbital/luminal

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use of long acting barb

phenobarbital/luminal - seizure disorders primarily - most commin - oldest med for seizure

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how is long acting barb used

phenobarbital/luminal - onset 1 hr- duration 12 hours

would you use a benzo or barb/phenobarbital as sedative

benzos are more commonly used as sedative over phenobarbatol

what sedative drug is used as anti seizure more than sedative

barbituate - phenobarbital/luminal

what is the concern if mixing barbituates with alcohol

respiratory depression

MOA of benzodiazapines

bind adjacent to GABA receptors - which increases GABA receptors affinity to GAPA

what ion channel does binding GABA open

Chloride ion channel - hyperpolarize neuron making it difficult to send excitatory signals.

what 2 things can benzodiazepines be used for

seizures and muscle spasms- and then maybe anxiety

what is a common short acting Benzo

alprozolan/xanax and midazolam/versed

what is midaxolam/versed used for

short acting benzo-before endoscopy as sedation and anti anxiety

Properties of versed

Benzo - sedative- anticonvulsant- amnestic retrograde amnesia muscle relaxant

what are longer duration benzos used for

insomnia and anxiety

longer duration benzo

Diazepam/valium - often used for seizure disorders

how is versed used

benzo short acting - IV - syrup used for children

when is diazepam/valium often used

Benzo - long acting - break through seizures in addition of anxiety and insomnia

side effects of Valium

benzo - long acting - tolerance addiction drowsiness- rebound insomnia

what is the benzo like sedative

zolpidem/ambien - eszopiclone/lunesta

indication for benzo like sedatives

insomnia - it helps to fall asleep

MOA of eszopiclone/lunesta

binds a receptor site adjacent to GABA although its different than the Benzo sight- it then helps GABA bind and keep the cloride ion channels open- hyperpolarizing nerve and supressing excitatory impulses

side ieffects of eszopiclone/lunesta

benzo like sedative - mental effects before it actually allows you to fall asleep. Little drowsiness upon waking

what is the melatonin agonist

Ramelton/Rozerem - newest class of sedative hyponics

MOA of Ramelton/Rozerem

melatonin agonist - binds to MT1 and MT2 receptors to enhance action of endogenous melatonin helping maintain circadian rythem

is Ramelton/Rozerem more or less affective than just melatonin

melatonin agonist - nothing says its better or worse

what is benzo withdrawl syndrome

diazepam/valium - seizures and life threatening tachycardia and HTN

benzo overdose symptoms

diazepam/Valium - CNS depression- impaired balance- ataxia and slurred speech

antidote to benzo/valium

flumazenil/Romazicon - respiratory and CNS depression reversal

moa of rlumazenil/romazicon

benzo receptor antagonist to reverse benzo effects

how is Flumazenil/romazicon given

IV only - 2 min onset - one hour half life.

romazicon - as a benzo antidote- what overdose effect is it not as good at reversing

Flumazenil/romazicon is not good at reversing respiratory depression

what can flumazenil/romazicon cause

withdrawl symptoms like seizures