Sedative Hypnotics

Question 1

Enhance gaba to depress cns
Drug/dose relationship is linear
Duration limited by distribution

Sleepiness, drowsiness, confusion, sedation

Not antagonized by Flumazenil

Answer 1

Barbiturates

Question 2

Available in different forms of administration

Answer 2

Pentobarbital, methohexinal, phenobarbital

Barbiturates

Question 3

Enhance gaba
Keep rmp more negative
2 subtypes

Inhibited by Flumazenil
Metabolized by liver

Cns depression, drowsiness, dizzy, rebound insomnia, amnesia

Irritation and aggression in children

Answer 3

Benzodiazepines

Question 4

Skip step two in liver metabolism?

Answer 4

Oxazepam and lorazepam

Question 5

Eszopiclone
Zaleplon
Zolpidem

Answer 5

Non BZD- work at BZD receptor site and also antagonized by Flumazenil

Question 6

Alprazolam 
Chlordiazepam
Clonazapam
Clorazepate
Diazepam 
Lorazepam
Oxazepam

Answer 6

BZD for anxiety

Question 7

Estazolam 
Flutazepam 
Quazepam
Temazepam
Triazolam

Answer 7

BZD for insomnia

Question 8

Buspirone

Answer 8

Anti anxiety, delayed onset, low serotonin release, drug interactions, short half life
-takes 2 weeks for full effect

Non BZD or barbiturate sedative hypnotic

Question 9

Ramelteon

Answer 9

Insomnia
Affects sleep wake cycle
Next day impairment

Melatonin receptor agonist

Question 10

Tasimelton

Answer 10

Non-24
Affects sleep wake cycle
Next day impairment

Melatonin receptor agonist

Question 11

Highly lipid soluble 
Fast onset 
Termination due to redistribution 
Most metabolized by liver 
Duration of t1/2 varies 
Enhance GABA
Two classes 

Sleepiness, drowsiness, confusion, sedation

Risk of dependence varies

Answer 11

All sedative hypnotics

Question 12

Suvorexant

Answer 12

Orexin receptor agonist Insomnia, next day impairment
Affects sleep/wake cycle
Decreases appetite

Non BZD or barbiturate sedative hypnotic