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Pharm Exam > Sedative-Hypnotics and Alcohol > Flashcards

Sedative-Hypnotics and Alcohol Flashcards

1
Q

Anxiety is usually ___ to other disorders

A

Anxiety is usually secondary to other disorders

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2
Q

What is anxiety?

A

Feelings of fear, tension, apprehension, etc.

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3
Q

The best way to treat anxiety is often to…

A

Treat the underlying illness

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4
Q

What are sedative-hypnotics?

A

Benzodiazepines and barbiturates.

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5
Q

What are anxiolytic drugs?

A

Sedative drugs that help treat anxiety without impacting motor or mental function

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6
Q

What are hypnotics?

A

Drugs that produce drowsiness and induce sleep

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7
Q

What are benzodiazepines?

A

Drugs that bind to a separate site on GABAa receptors and increase the frequency of Cl-channel openings.

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8
Q

No matter how high the dose, benzodiazepines require ____ for their effects.

A

They only work in the presence of GABA

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9
Q

Give an example of a benzodiazepine

A

Diazepam (VALIUM)

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10
Q

How is diazepam broken down?

A

Phase I: Diazepam is oxidized by cytochrome P450

Its metabolites are active (they produce the same calming effects)

Phase II: Interaction with glucuronide makes it passable in urine

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11
Q

What is an example of a barbiturate?

A

Phenobarbital

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12
Q

What makes barbiturates different from benzodiazepines like Diazepam?

A

They have a smaller safety margin

Their metabolites are generally not active

At high doses, barbituates can directly activate GABAa receptors

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13
Q

Barbiturates can increase the expression of some cytochrome p450 enzymes which is…

A

dangerous because cytochrome p450 plays a big role in drug metabolism, it messes with the breakdown rates of other drugs.

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14
Q

Both benzodiazepines and barbiturates enhance Cl- conductance which…

A

Increases the inhibition of many neurons all throughout the brain

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15
Q

Benzodiazepines and barbiturates bind to ____ sites on GABAa receptors

A

different sites, meaning their effects can stack

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16
Q

Sedative hypnotics are used to treat…

A

Anxiety, insomnia, psychosis, epilepsy, alcohol withdrawl

17
Q

Before surgery, sedative-hypnotics are given as part of the

A

anesthesia process

18
Q

What are some of the adverse effects of sedative-hypnotics (benzos and barbiturates)

A

Dose-dependent CNS depression (ranging from impaired motor skills -> coma -> death) *CNS depression can combine with other drugs ex. alcohol

Withdrawal symptoms after prolonged use

Tolerance will develop

Extra toxic if liver function is impaired

19
Q

How does THC regulate anxiety?

A

the endocannabinoid system regulates anxiety by dampening excitatory glutamate signals (THC decreases glutamate release)

20
Q

How does marijuana become addictive?

A

Chronic marijuana use down-regulates receptors, leading to increased anxiety due to a lack of receptors available for the natural endocannabinoid system

21
Q

Endocannabinoids work by ____ by activating CB1 receptors

A

inhibiting transmitter release by activating CB1 receptors

22
Q

Marijuana contains compounds which…

A

activate CB1 receptors

23
Q

Overall THC is responsible for reducing the release of both ____

A

Glutamate and GABA

24
Q

What is ethanol?

A

Beer, wine, rum etc

25
Q

What are the acute effects of ethanol?

A

DOSE DEPENDANT CNS depression
Decreased membrane excitability

Increased GABAa activation

Decreased NMDA activation

26
Q

How does ethanol impact myocardial contractility?

A

Initially, it is increased, then it decreases.

27
Q

What are the behavioral effects of ethanol?

A

Decreased anxiety, impaired judgement, slurred speech

28
Q

What happens when a toxic dose of ethanol is taken?

A

CNS and respiratory depression

29
Q

What are the chronic effects of ethanol use?

A

liver failure

pancreatitis and gastritis

malnutrition

30
Q

How is 90% of ethanol metabolized?

A

In the liver

Major pathway: alcohol dehydrogenase
Minor pathway: cytochrome p450

31
Q

How is the last 10% of ethanol metabolized?

A

Its excreted in the lungs and urine

32
Q

Alcohol has a ___ clearance rate

A

constant clearance rate

33
Q

How is ethanol different from methanol?

A

Methanol has the same CNS depression effects

When metabolized, methanol turns into formic acid -> builds up in retina -> blindness

34
Q

How do you treat methanol poisoning?

A

With ethanol

Ethanol has a higher affinity for alcohol dehydrogenase so the formic acid levels won’t peak as high

Pharm Exam (11 decks)

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