Sedative/Hypnotic Agents

Question 0

Barbiturate intoxication

Answer 0

Narrow therapeutic index

Overdose can be fatal, tx only supportive

Question 1

Mechanism of action of Barbiturates

Answer 1

Allosteric agonists of GABA-A receptors

Potentiates action of GABA (inhibitory effect)

Question 2

Benzodiazepines for hypnotic use

Answer 2

Triazolam

Flurazepam

Question 3

Triazolam

Answer 3

Benzodiazepine
Short half-life, low daytime drowsiness
Rebound insomnia can occur
Anterograde amnesia is higher

Question 4

Flurazepam

Answer 4

Benzodiazepine 
Long acting
Residual anti anxiety effect
Not for long term daily use
Daytime drowsiness

Question 5

Zolpidem

Answer 5

Non-benzodiazepine benzodiazepine receptor agonist on GABA
Drowsiness, drugged feeling, dizziness
Les risk of dependence
*lower dose for women by 1/2
*increased incidence of somnambulism, sleeping eating, sleep driving etc.

Question 6

Ramelteon

Answer 6

Melatonin receptor agonist
Thought to play a role in initiating sleep
Quick acting, may work for circadian rhythm problems
Effectiveness not clearly established -given for jet lag

Question 7

Secobarbital

Answer 7

Barbiturate
Narrow therapeutic index
Strong physical dependence

Question 8

Barbiturates

Answer 8

Phenobarbital
Secobarbital
Thiopental