Sedative-hypnotics Flashcards
Exam 3
What are the 5 classes of sedative-hypnotics?
- Benzodiazepines - Diazepam, Midazolam
- Barbituates - Phenobarbital
- Sleep aids - Zolpidem (non-benzodiazepine)
- Anxiolytics - Buspirone
- Ethanol
GABAa receptors are activated by what?
GABA
How do sedative-Hypnotics potentiate inhibition at all levels of CNS via GABAa receptors?
- Increased flow through channel
- Increased channel opening time
Sedation vs hypnosis
Sedation - calming, anxiolytic
Hypnosis - encourages sleep
Differentiate between desirable and less desirable effects of hypnotics on sleep?
Desirable:
- Decreased time to fall asleep
- Increased stage 2 NREM (non-rapid eye movement) sleep
Less Desirable:
- Decreased REM (rapid eye movement) sleep
- Decreased stage 4 NREM slow-wave sleep
Which sedative-hypnotics are useful anesthesia adjuncts?
Barbituates – thiopental and methohexital
Benzodiazepines - diazepam, lorazepam, and midazolam
What is the reversible agent for Benzodiazepines?
flumazenil
What class of sedative-hypnotics can contribute to a persistent postanesthetic respiratory depression?
Benzodiazepines
Where is alcohol metabolized?
Liver: 90% (remainder in lungs and stomach)
- zero-order kinetics
What are the standard alcoholic drink sizes?
Beer - 10oz
Wine - 3.5oz
Liquor - 1oz
Adults can metabolize how many alcoholic drinks per hour?
1
What are the 2 major pathways of metabolism to acetaldehyde?
Alcohol dehydrogenase pathway
Microsomal ethanol-oxidizing system (MEOS)
Differentiate between tolerance, dependence, and addiction
Tolerance – More of the drug is needed to get the same initial effect
Dependence – Body is now reliant on drug
Addiction – Behavior – will seek out drug regardless of negative consequences
What is the most common neurologic abnormality
from ethanol consumption?
Generalized symmetric peripheral nerve injury
- Distal paraesthesias of hands and feet
What are the other neurological disorders that can be induced by alcohol consumption?
- Gait disturbances, ataxia
- Optic nerve degeneration
- Dementia, demyelinating disease