Sedative-Hypnotic Agents

Question 1

Benzodiazepines

Answer 1

Most effective drug for rapid relief of acute anxiety symptoms like panic attacks

Most end in -pam

Question 2

Benzodiazepine Pharmacokinetics

Answer 2

Contraindicated in Pregnat woman due to crossing placental border.
Detectable in Breast milk so not in nursing mothers

Question 3

Benzodiazepine pharmacodynamics

Answer 3

GABA Receptor is targeted and the Cl- channel is kept open

Question 4

Long term treatments for Generalized Anxiety Disorder

Answer 4

SSRIs and SNRIs

They reduce somatic anxiety symptoms by activating stress-adapting neuronal pathways

Question 5

Buspirone

Answer 5

Selective anxiolytics effects without sedation, hypnosis, or euphoria…still second line agent because of inconsistent reports of efficacy.

Doesn’t work acutely…takes two weeks to see improvements

Question 6

Hypnotic Agents used to treat Insomnia

Answer 6

GABAergics- BZ’s + Zalepon + Zolpidem + Lunesta

Ramelteon
Suvorexant

Question 7

BZ’s as sleep treatment

Answer 7

Increase sleep time and decrease sleep latency

Question 8

Non BZ hypnotics

Answer 8

Zolpidem, Zaleplon, Eszopiclone\

Similar method of action to BZ (GABAergic)

Decrease latency,
Increase total sleep time (EXCEPT ZALEPLON)

Question 9

Ramelteon

Answer 9

Melatonin receptor agonist

Decrease sleep latency and increase sleep periods, no risk of dependence or rebound insomnia.
Also used for sleep apnea

Question 10

Suvorexant

Answer 10

Orexin antagonist
Decreases sleep latency and increase total sleep time.RISK of abuse/dependence.
“Sleep-Driving” side effect