Sedative Hypnotics Flashcards
Intermediate acting BZD used for seizure disorder and as tranquilizers?
Lorazepam
Short acting BZD used for anesthesia induction and preop sedation?
Midazolam
Long acting BZD used as tranquilizer and for alcohol withdrawal?
Diazepam
BZD for status epilepticus?
Loraz (Int) and Diaz (Long)
Preferred BZD for skeletal muscle relaxation as in cerebral palsy?
Diazepam
Long acting
Preferred BZD for phobias and panic disorders?
Alpraz. Clonazepam
Intermediate acting
Preferred BZD for anesthesia induction?
Midaz, Diaz
Preferred BZD for alcohol withdrawal?
Long acting!
Diazepam and Chlordiazepoxide
MOA of BZD vs Barbiturates?
Frenzodiazepenes and Barbiduration
Inc frequency/duration of opening of chloride channels
Common AE of BZD?
- Rebound insomnia (more common in short acting-Midaz)
- Anterograde amnesia
- Unwanted daytime symptoms (Long-Diaz)
Examples of date rape drugs
- Alcohol
- Flunitrazepam
- Gamma hydroxybutyrate
“Rapists are FAGs”
BZD with longest half-life?
Chlordiazepoxide
Antidote for BZD overdose?
Flumazenil - GABA receptor antag
Precipitate BZD withdrawal syndrome
CYP450 Inducers?
Ethel Barbie takes Phen, Refuses Greasy Carb Shakes
Ethanol, Barbiturates, Phenytoin, Rifampicin, Griseofulvin, Carbamazepine, Smoking
Ultrashort acting barbiturate for anesthesia induction and increased ICP?
Thiopental
TAYO AGAD
AE of barbiturates?
- Acute intermittent porphyria (problem with heme synthesis-anemia)
- CNS depression
- Tolerance
What enzyme is deficient in acute intermittent porphyria?
HMB synthase (Hydroxymethylbilane)
What enzyme is deficient in porphyria cutanea tarda?
Uroporphyrinogen decarboxylase
Long acting barbiturate for hyperbilirubinemia (GIlbert’s=unconjugated)?
Phenobarbital
Most catastrophic symptom of sedative hypnotic withdrawal?
Rebound suicide :(
Imidazopyridine that act as BZD versus insomnia?
Less dependence liability
Zolpidem
ZZZolpidem - Zleep disorders
Anxiolytic drug, partial agonist at 5HT1a receptors for generalized anxiety disorder?
Buspirone
BUSpirone for BUSy people
Drugs with disulfiram like reactions?
Clara took premed test in PM
Chlorpropamide, CefoPerazone, CefoMandole, CefoTetan, Procarbazine, Metronidazole
Level of alcohol that causes respiratory depression and death?
> 500mg/dL
Alcohol most commonly causes what cardiovascular defect?
Reversible DCM
vs. Doxorubicin (irreversible)
Protective dose of ethanol?
10-15g/day increases HDL, protect against CAD
Neurologic abnormalities in chronic alcohol intoxication? In alcohol withdrawal?
Wernicke Korsakoff - Weird ACO, CHA
Ataxia, Confusion, Ophthalmoplegia
Confabulation, Hallucinations, Amnesia
Also in vit B1 deficiency
Neurologic abnormalities in alcohol withdrawal?
Delirium tremens - HAD 48
Hallucinations, Autonomic instability, Delirium
48-72 hours post-discontinuation
Treatment of alcoholism?
Acamprosate - NMDA receptor antag
Naltrexone - opioid antag
Disulfiram
Antidote for methanol poisoning? Methanol may cause blindness
ETHANOL - compete with methanol for alcohol DH
Decrease formaldehyde and formic acid levels
Antidote for ethylene glycol poisoning?
Ethanol and Fomepizole
Decreases Oxalic acid - prevent renal damage and acidosis
Congenital defect caused by alcohol? By phenytoin?
Fetal alcohol syndrome - MR, microcephaly, hypoplastic midfacial area
Fetal hydantoin syndrome - midfacial and distal digital hypoplasia
