Sedative and Hypnotic Drugs

Question 1

diazepam

Answer 1

• benzodiazepine
• binds to GABA-A receptors and facilitate GABA mediated Cl- channel opening frequency
• causes sedation, anxiolysis, amnesia, hypnosis, anesthesia, and coma
• metabolized by CYP3A4
• risk of death d/t respiratory depression when combined with opioids, EtOH etc…
• risk of drowsiness, addiction

Question 2

alprazolam

Answer 2

• ANXIETY DRUG
• benzodiazepine
• binds to GABA-A receptors and facilitate GABA mediated Cl- channel opening frequency
• causes anxiolysis, sedation, amnesia, hypnosis, anesthesia, and coma
• metabolized by CYP3A4
• risk of death d/t respiratory depression when combined with opioids, EtOH etc…
• risk of drowsiness, addiction

Question 3

clonazepam

Answer 3

• ANXIETY DRUG

- benzodiazepine

Question 4

lorazepam

Answer 4

• ANXIETY DRUG

- benzodiazepine

Question 5

temazepam

Answer 5

• INSOMNIA DRUG
• benzodiazepine
• binds to GABA-A receptors and facilitate GABA mediated Cl- channel opening frequency
• causes ANTEROGRADE AMNESIA, anxiolysis, sedation, hypnosis, anesthesia, and coma
• metabolized by CYP3A4
• risk of death d/t respiratory depression when combined with opioids, EtOH etc…
• risk of drowsiness, addiction

Question 6

triazolam

Answer 6

• INSOMNIA DRUG

- benzodiazepine

Question 7

midazolam

Answer 7

• PRE-OP SEDATION, ANXIOLYSIS, AND AMNESIC DRUG
• benzodiazepine
• binds to GABA-A receptors and facilitate GABA mediated Cl- channel opening frequency
• causes anxiolysis, sedation, amnesia, hypnosis, anesthesia, and coma
• metabolized by CYP3A4
• risk of death d/t respiratory depression when combined with opioids, EtOH etc…
• risk of drowsiness, addiction

Question 8

zolpidem

Answer 8

• INSOMNIA DRUG
• selective BZ1 type GABA-A receptor ligand (non-benzodiazepine)
• causes rapid hypnosis
• metabolized by CYP3A4
• risk of abnormal sleep behaviors: sleep walking, sleep driving

Question 9

flumazenil

Answer 9

• antagonist at benzodiazepine binding sites on GABA-A receptor
• BLOCKS ACTION of benzodiazepines and zolpidem
• used to manage benzo overdose
• risk of seizures, agitation/confusion

Question 10

phenobarbital

Answer 10

• long acting barbiturate used to treat seizure
• open GABA receptor gated Cl- channels WITHOUT GABA
• risk of death d/t respiratory depression
• INDUCE CYP3A4

Question 11

pentobarbital

Answer 11

• intermediate acting barbiturate used as a sedative/hypnotic
• open GABA receptor gated Cl- channels WITHOUT GABA
• risk of death d/t respiratory depression
• INDUCE CYP3A4

Question 12

thiopental

Answer 12

• short acting barbiturate used as IV anesthetic
• open GABA receptor gated Cl- channels WITHOUT GABA
• risk of death d/t respiratory depression
• INDUCE CYP3A4

Question 13

buspirone

Answer 13

• nonbenzodiazepine anxiolytic
• no tolerance, addiction, or withdrawal
• metabolized by CYP3A4
• risk of insomnia, agitation, nausea

Question 14

ramelteon

Answer 14

• INSOMNIA DRUG
• melatonin agonist
• activated MT1 and MT2 receptors in suprachiasmatic nuclei
• no addiction or withdrawal

Question 15

suvorexant

Answer 15

• INSOMNIA DRUG
• blocks binding of orexins to cause sleepiness
• some abuse potential

Question 16

doxepin

Answer 16

• H1 receptor antagonist
• blocks reuptake of NE and 5-HT
• causes sedation
• risk of increased suicidal ideation, anticholinergic effects, CNS depression