Sedative Hypnotic drugs, Anti-anxiety drugs, and muscle relaxants Flashcards
What is the general progression of CNS-depressing effects?
Anxiolysis Sedation Hypnosis Anesthesia Respiratory failure
What is sedation?
Relaxation, calmness, decreased motor activity without loss of consciousness
What is hypnosis?
Drowsiness, depressed state of consciousness and decreased motor activity resembling sleep, but with impaired sense of responsiveness
What is Anesthesia?
A state of unconsciousness without possibility of arousal
T/F - All CNS-depressive drugs are suitable as sedatives
False
What is a muscle spasm?
The result of faulty coordination of the spinal cord mediated reflex arc mediating control of movement
What are some reasons nerves might fire inappropriately?
Electrolyte imbalance
Faulty vertebrae
Others
What are the two major classes of drugs of the sedative-hypnotic, and anti-anxiety type?
Benzodiazepines
Barbituates
What do sedative-hypnotic, and anti-anxiety drugs do?
Increase Cl conductance via action at GABA-A receptors, but they do it slightly differently
What is the difference between GABA-A and GABA-B
GABA-A = Ligand gated ion channel GABA-B = GPCR
How do GABA-B channels hyperpolarize cells?
They hyperpolarize by activating K channels via GBGy
They also diminish Ca entry into cells
Which GABA receptors do Barbituates and Benzodiazepines act on?
GABA-A
T/F - Barbituates and Benzodiazepines work at the same binding sites of GABA-A
False
What affect do Barbituates do on GABA receptors?
They increase the duration of GABA-mediated channel opening
What affect do Benzodiazepines on GABA receptors?
They increase the frequency of GABA-mediated channel opening
T/F - Both Barbituates and Benzodiazepines produce hyperpolarization and decrease excitability
True
What are some clinical effects of Benzodiazepines?
Dose dependent suppression of the CNS Drowsiness and sedation for some Don't produce ataxia or somnolence Sometimes amnesia Anti-seizures Muscle relaxants
What is Flumazenil?
A benzodiazepine antagonist
- can be used to manage benzodiazepine overdose
- can be used for recovery from benzodiazepine sedation - IV administration can reverse in 1-2 minutes
What are benzodiazepines used more than tranquilizers?
Less potential for abuse (less dependency)
Better theraputic index
What is Zolpidem?
Non-benzodiazepine sedative
Structurally unrelated but binds to the same location
Don’t need as much dosage
Can be used to treat insomnia
What are clinical effects of Barbituates?
Dose dependent suppression of the CNS (ranging from mild sedation to respiratory arrest)
Reticular formation is especially sensitive
What can be use as sedative-hypnotic drug in dentistry?
Barbituates
What can be used to treat anxiety/retrograde amnesia in dentistry?
Benzodiazepines in conjunction with local anesthetics
What drugs can be used to treat anesthetic-induced seizures?
Benzodiazepines
