Sedative Hypnotic drugs, Anti-anxiety drugs, and muscle relaxants

Question 1

What is the general progression of CNS-depressing effects?

Answer 1

Anxiolysis
Sedation
Hypnosis
Anesthesia
Respiratory failure

Question 2

What is sedation?

Answer 2

Relaxation, calmness, decreased motor activity without loss of consciousness

Question 3

What is hypnosis?

Answer 3

Drowsiness, depressed state of consciousness and decreased motor activity resembling sleep, but with impaired sense of responsiveness

Question 4

What is Anesthesia?

Answer 4

A state of unconsciousness without possibility of arousal

Question 5

T/F - All CNS-depressive drugs are suitable as sedatives

Answer 5

False

Question 6

What is a muscle spasm?

Answer 6

The result of faulty coordination of the spinal cord mediated reflex arc mediating control of movement

Question 7

What are some reasons nerves might fire inappropriately?

Answer 7

Electrolyte imbalance
Faulty vertebrae
Others

Question 8

What are the two major classes of drugs of the sedative-hypnotic, and anti-anxiety type?

Answer 8

Benzodiazepines

Barbituates

Question 9

What do sedative-hypnotic, and anti-anxiety drugs do?

Answer 9

Increase Cl conductance via action at GABA-A receptors, but they do it slightly differently

Question 10

What is the difference between GABA-A and GABA-B

Answer 10

GABA-A = Ligand gated ion channel
GABA-B = GPCR

Question 11

How do GABA-B channels hyperpolarize cells?

Answer 11

They hyperpolarize by activating K channels via GBGy

They also diminish Ca entry into cells

Question 12

Which GABA receptors do Barbituates and Benzodiazepines act on?

Answer 12

GABA-A

Question 13

T/F - Barbituates and Benzodiazepines work at the same binding sites of GABA-A

Answer 13

False

Question 14

What affect do Barbituates do on GABA receptors?

Answer 14

They increase the duration of GABA-mediated channel opening

Question 15

What affect do Benzodiazepines on GABA receptors?

Answer 15

They increase the frequency of GABA-mediated channel opening

Question 16

T/F - Both Barbituates and Benzodiazepines produce hyperpolarization and decrease excitability

Answer 16

True

Question 17

What are some clinical effects of Benzodiazepines?

Answer 17

Dose dependent suppression of the CNS
Drowsiness and sedation for some
Don't produce ataxia or somnolence
Sometimes amnesia
Anti-seizures
Muscle relaxants

Question 18

What is Flumazenil?

Answer 18

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

Question 19

What are benzodiazepines used more than tranquilizers?

Answer 19

Less potential for abuse (less dependency)

Better theraputic index

Question 20

What is Zolpidem?

Answer 20

Non-benzodiazepine sedative
Structurally unrelated but binds to the same location
Don’t need as much dosage
Can be used to treat insomnia

Question 21

What are clinical effects of Barbituates?

Answer 21

Dose dependent suppression of the CNS (ranging from mild sedation to respiratory arrest)
Reticular formation is especially sensitive

Question 22

What can be use as sedative-hypnotic drug in dentistry?

Answer 22

Barbituates

Question 23

What can be used to treat anxiety/retrograde amnesia in dentistry?

Answer 23

Benzodiazepines in conjunction with local anesthetics

Question 24

What drugs can be used to treat anesthetic-induced seizures?

Answer 24

Benzodiazepines