Pharmacodynamic- Organ level effect Flashcards
Sedation— Benzodiazepines, barbiturates, and most older
sedative-hypnotic drugs exert ___________
calming effects with concomitant
reduction of anxiety at relatively low doses.
In most cases, however,
the anxiolytic actions of sedative-hypnotics are accompanied
by some depressant effects on ____________
psychomotor and cognitive
functions.
In experimental animal models, benzodiazepines and
older sedative-hypnotic drugsare able to disinhibit ___________
This disinhibition has been equated with
antianxiety effectsof sedative-hypnotics, andit is not a characteristic
of all drugs that have sedative effects, eg, the tricyclic
antidepressants and antihistamines.
punishmentsuppressed
behavior.
However, the disinhibition
of previously suppressed behavior may be more related to behavioraldisinhibitory effects of sedative-hypnotics, including
_____________which can
occur at dosages in the range of those used for management of
anxiety.
- euphoria,
- impaired judgment,
- and loss of self-control,
The benzodiazepines also exert dose-dependent ____________________(inability to remember events occurring
during the drug’s duration of action).
- *anterograde**
- *amnesic effects**
Organ Level Effects
- Sedation
- Hypnosis
- Anesthesia
- Anticonvulsant effects
- Muscle relaxation
- Effects on respiration and cardiovascular function
By definition, all of the sedative-hypnotics
induce sleep if high enough doses are given. The effects of sedativehypnotics
on the stages of sleep depend on several factors,
including the specific drug, the dose, and the frequency of its
administration. The general effects of benzodiazepines and older
sedative-hypnotics on patterns of normal sleep are as follows:
(1) the latency of sleep onset is decreased (time to fall
asleep) ;
(2) the duration of stage 2 NREM (nonrapid eye movement)
sleep is increased;
(3) the duration of REM sleep is decreased; and
(4) the duration of stage 4 NREM slow-wave
sleep is decreased.
A sedative is a drug that **produces a relaxing, calming effect. **
Sedatives are usually given during daytime hours,and although they may make the patient drowsy, they usually **do not produce sleep. **
A hypnotic is a drug that induces sleep, that is, it allows the patient to fall a sleep and stay a sleep.
Hypnotics also may be called soporifics. Hypnotics are given at night or hour of sleep (HS).
The newer hypnotics all decrease the____________
latency
to persistent sleep.
__________-decreases REM sleep but has
minimal effect on slow-wave sleep.
Zolpidem
- *_________**decreases the
- *latency of sleep onset w**ith little effect on total sleep time,
- *NREM, or REM sleep.**
**Zaleplon **
____________ increases total sleep time,
mainly via increases in stage 2 NREM sleep, and at low doses has
little effect on sleep patterns. At the highest recommended dose,
decreases REM sleep.
Eszopiclone
More rapid onset of sleep and prolongation of stage 2 are
presumably clinically useful effects.
However, the significance of
sedative-hypnotic drug effects on REM and slow-wave sleep is
not clear.
Deliberate interruption of REM sleep causes anxiety
and irritability followed by a rebound increase in REM sleep at
the end of the experiment.
A similar pattern of “REM rebound”
can be detected following** abrupt cessation of drug treatment
with older sedative-hypnotics,**especially when drugs with _______________
short
durations of action (eg, triazolam) are used at high doses.
With
respect to_____________ there is little
evidence of REM reboundwhen these drugs are discontinued
after use of recommended doses.
zolpidem and** the other newer hypnotics,**