Sedative-Hypnotic-Anxiolytic Drugs

Question 1

Binding site for benzodiazepines?

Answer 1

on the alpha gamma interface
BZ 1receptor
BZ 2 receptor

Question 2

GABA A activation increases influx of what ion?

Answer 2

Cl- influx

Question 3

GABA B activation increase efflux of what ion?

Answer 3

K+ efflux

Question 4

BZ1 stimulation typically mediates what affects?

Answer 4

sedation

Question 5

BZ 2 stimulation typically mediates what effects?

Answer 5

anti anxiety and impairment of cognitive functions

Question 6

Antidote for benzodiazepines?

Answer 6

flumazenil

Question 7

T/F. Barbiturates inhibit complex I of electron transport chain?

Answer 7

true

Question 8

What is the common suffix for benzos?

Answer 8

zolam
zepam

Question 9

Which drug, barbs or benzos, increase frequency of Cl- channel opening?

Answer 9

benzos

Question 10

Which drug, barbs or benzos, increase duration of Cl- channel opening?

Answer 10

barbs

Question 11

One benzodiazepine that doesn’t follow the zolam and zepam rule?

Answer 11

chlordiazepoxide

Question 12

Indication for Alprazolam.

Answer 12

anxiety, panic, phobias

Question 13

Indication for Diazepam.

Answer 13

anxiety, preop sedation, muscle relaxation, withdrawal states

Question 14

Indication for Lorazepam

Answer 14

anxiety, preop sedation, status epilepticus (IV)

Question 15

Indication for Midazolam. What is a good benefit for using this drug when performing certain procedures like colonoscopy?

Answer 15

Preop sedation, induction anesthesia IV

can cause anterograde amnesia

Question 16

Indication for Temazepam

Answer 16

Sleep disorders

Question 17

Indication Oxazepam

Answer 17

sleep disorders, anxiety

Question 18

Barbiturates are contraindicated in patients with what condition?

Answer 18

porphyrias

Question 19

Distinguish what type of anxiety BZs are effective in treating vs SSRIs and SNRIs?

Answer 19

BZs acute anxiety while SSRIs and SNRIs are more for chronic anxiety

Question 20

Can there be cross-tolerance between BZs, barbs, and ethanol?

Answer 20

yes

Question 21

What are some withdrawal rebound signs of BZs?

Answer 21

• rebound insomnia
• anxiety
• seizure when BZs were used as anti epileptic or in high doses

Question 22

Withdrawal signs of barbs and ethanol?

Answer 22

anxiety, agitation, life-threatening seizures like (delirium tremens with alcohol)

Question 23

What are some ways to manage withdrawal symptoms from barbs and alcohol?

Answer 23

supportive and long-acting BZs

Question 24

Drug interactions of GABA-A drugs?

Answer 24

additive with other CNS depressants (possible life-threatening respiratory depression) such as anesthetics, antihistamines, opiates, B-blockers, etc.

-barbiturates induce metabolism of lipid soluble drugs like OCs, carbamazepine, phenytoin, warfarin, etc.

Question 25

Non Bz drugs that stimulate BZ1 receptors.

Answer 25

Zolpidem and Zaleplon

Question 26

Indications for Zolpidem and Zaleplon?

Answer 26

sleep disorders

Question 27

Is there less or more abuse liability and tolerance with the use of Zolpidem or Zaleplon? What is a S/E of them?

Answer 27

less tolerance and abuse liability (sleepwalking)

Question 28

MOA of Buspirone.

Answer 28

5-HT1A partial agonist

Question 29

Indications for Buspirone?

Answer 29

GAD

Question 30

Does Buspirone have sedative properties?

Answer 30

non sedative

Question 31

What is an important thing to note and/or let the patient know if you prescribe buspirone?

Answer 31

may take 1 to 2 weeks for effects

Question 32

Suvorexant MOA.

Answer 32

orexin promotes wakefulness

Suvorexant blocks orexin leading to sedation

Question 33

Indication suvorexant.

Answer 33

insomnia