Pharmacology V

Question 1

Name eight benzodiazepines.

Answer 1

Diazepam, lorazepam, triazolam, temazepam, oxazepam, midazolam, chlordiazepoxide, alprazolam (p.453)

Question 2

What is the mechanism of action of benzodiazepines?

Answer 2

To facilitate GABA(a) action by increasing FREQUENCY of Cl- channel opening (p.453)

Question 3

How do benzodiazepines effect sleep patterns?

Answer 3

Decrease REM sleep (p.453)

Question 4

Which benzodiazepines have short half lives?

Answer 4

Triazolam, oxazepam, midazolam are short acting (p.453)

Question 5

What is an important consideration when prescribing short acting vs long acting benzodiazepines?

Answer 5

Short acting benzos are more addictive (p.453)

Question 6

Name seven clinical uses for benzodiazepines.

Answer 6

Anxiety, spasticity, status epilepticus (lorazepam, diazepam), detoxification (especially alcohol withdrawal- DTs), night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxation), hypnotic (insomnia) (p.453)

Question 7

What toxicities are associated with benzodiazapines?

Answer 7

Dependence, additive CNS depression effects with alcohol (p.453)

Question 8

Compare the overdose risk of benzodiazepines to barbiturates.

Answer 8

Benzodiazapines have less risk of respiratory depression and coma (p.453)

Question 9

How is benzodiazepine overdose treated?

Answer 9

Flumazenil (p.453)

Question 10

What is the mechanism of action of Flumazenil?

Answer 10

Competitive antagonist at GABA benzodiazepine receptor (p.453)

Question 11

Which three drug classes will bind at the GABA(a) receptor (a ligand gated chloride channel)?

Answer 11

EtOH, benzos, barbiturates (p.453)

Question 12

Name three nonbenzodiazepine hypnotics.

Answer 12

Zolpidem (Ambien), zaleplon, eszopiclone (p.453)

Question 13

What is the mechanism of action for nonbenzodiazepine hypnotics?

Answer 13

Act via the BZ1 subtype of the GABA receptor (p.453)

Question 14

What reverses the effects of nonbenzodiazepine hypnotics?

Answer 14

Flumazenil (p.453)

Question 15

What are nonbenzodiazepine hypnotics use for?

Answer 15

Insomnia (p.453)

Question 16

What toxicities are associated with nonbenzodiazepine hypnotics?

Answer 16

Ataxia, headaches, confusion (p.453)

Question 17

What is the typical duration of nonbenzodiazepine hypnotics?

Answer 17

Short duration due to rapid metabolism by liver enzymes (p.453)

Question 18

What advantages do nonbenzodiazepine hypnotics have over other sedative-hypnotic drugs?

Answer 18

They cause only modest day-after psychomotor depression and few amnestic effects; carry lower dependence risk than benzos (p.453)

Question 19

How do anesthetic drugs enter the CNS?

Answer 19

CNS drugs must be lipid soluble to cross the BBB or must be actively transported (p.453)

Question 20

What property determines whether an anesthetic drug will have rapid induction and recovery times?

Answer 20

Drugs with decreased solubility in blood wil have rapid induction and recovery times (p.453)

Question 21

What is true of anesthetic drugs with increased solubility in lipids?

Answer 21

Greater potency (1/MAC) (p.453)

Question 22

What is MAC for anesthetic drugs?

Answer 22

Minimal alveolar concentration at which 50% of the population is anesthesized. It varies with age (p.453)

Question 23

Name an anesthetic with low blood and lipid solubility.

Answer 23

N2O; fast induction, low potency (p.453)

Question 24

Name an anesthetic with high blood and lipid solubility.

Answer 24

Halothane; high potency and slow induction (p.453)

Question 25

Name six inhaled anesthetics.

Answer 25

Halothane, enflurane, isoflurane, sevoflurane, methoxyflurane, nitrous oxide (p.453)