Pharm II, sedatives anxiolytics Flashcards
Physical sx of anxiety
tachycardia- trembling- sweating- palpationa
in general what do all of the anxity drugs have in common
sedative
what were the first antianxiety drugs to be discovered
barbiturates - they all have potent side effects
what will make anxiolytics moe sedative
adding alcohol
what are both barbituates and benzodiazepines noted for
tolerance - phycholocigal and physical dependence
receptors for benzos and barbs
bind adjacent to GABA receptors - which increases GABA receptors affinity to GAPA
what does GABA binding do
prolong Chloride ion channels
which drugs are rumored to be truth serum
barbiturates - they all have potent side effects
barbituates effect on pain
they do not have analgesic properties - it is used pre op to calm and to induce sleep prior to anesthesia
what are the 4 classifications of barbituates
ultra short - short- intermediated - long
ultra short acting barb
Thipental/Penthothal
how are ultra short acting barbs used
Thipental/Penthothal- IV - 1 minute
short acting barb
pentobarbitol/nembutal
how are short acting barbs used
pentobarbitol/nembutal - iv or ORAL 15-30 min onset- last 6-8 hrs
intermediate barb
butalbital/fiorinal talking about taking off market
how is intermediate barb used
butalbital/fiorinal - oral 20-40 min onset- lasting 6 hours
long acting barb
phenobarbital/luminal
use of long acting barb
phenobarbital/luminal - seizure disorders primarily - most commin - oldest med for seizure
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
