Sedative Hypnotics and Anti-Anxiety Drugs Flashcards
What do sedative or antianxiety agents cause?
Reduce anxiety w.o causing sleep.
What do hypnotic agents cause?
Physiologic sleep
Barbiturates are what kind of depressants?
CNS
Types of barbiturates.
1) Sodium Thiopental (general anesthesia)
2) Pentobarbital
3) Phenobarbital (epilepsy)
Use of barbiturates:
General anesthesia, epilepsy, euthanasia, capital punishment.
This drug class has replaced barbiturates bc they have a lower risk of overdose.
Benzodiazepines.
These are rarely ever indicated in modern sedation.
Barbiturates.
What determines barbiturate onset of action?
Lipid solubility.
The more soluble lipid soluble the barbiturate, the faster it gets into the CNS, and the faster it redistributes to adipose cells (so the shorter it’s duration of action).
Highly lipid soluble barbiturates.
Thiopental and Pentobarbital
Less lipid soluble barbiturate, so it has a slower onset of action, and longer duration.
Phenobarbital
Barbiturate MOA
Increase GABA binding.
These barbiturates are used for lethal injection.
Intermediate-acting barbiturates.
MOA of Benzodiazepines
Allosteric modulators of the GABA-A Receptor that increase the amount of GABA receptors that are open to bind GABA.
Increases GABA binding.
The major inhibitory NT in the CNS.
GABA
______ and __________ are positive allosteric modulators- they potentiate neuronal inhibition by GABA.
Benzodiazepines; non-benzodiazepines.
The effects of Benzodiazepines (Anxiolysis, sedation, hypnosis) are ______________.
Dose-dependent.
What are Benzodiazepines used for?
1) Anti-anxiety
2) Sedation-hypnosis
3) Anti-epileptic
4) Muscle relaxant
Sedation causes _______.
Hypnosis causes _______.
drowsiness; sleep
Benzodiazepines end in ___.
Azolam or Azepam
Short-acting Benzodiazepines that are used in sedation dentistry.
Midazolam and Triazolam
Intermediate-acting Benzodiazepines.
Lorazepam
Long-acting Benzodiazepine
Diazepam
Flumazenil is used for what?
To reverse Benzodiazepine overdose.
Half-life of Flumazenil.
40-80 minutes, so patients should be monitored for “resedation” and respiratory depression from persistent BDZ effects.
These drugs have proven effective as rapid-onset and short-acting sedatives that are safe at the recommended doses.
Hypnotic Benzodiazepine-like drugs (Z-Drugs)
Z drugs are __________-________ and are sedative-hypnotic.
Benzodiazepine-like
Why are Z drugs benzodiazepine-like?
Bc they bind to GABA-A receptors to increase GABA binding.
Flumazenil can be used to treat overdoses by which drug?
BDZ’s and Z-drugs.
Non-prescription anti-histamines that can be used as sedatives.
Diphenhydramine
Hydroxyzine
Promethazine
A weak opioid that can be used for pedo sedation.
Meperidine.
Triple Combo Sedation Cocktail for Pediatric Dentistry.
Chloral hydrate
Hydroxyzine
Meperidine
This drug does not promote physical dependence and associated withdrawal symptoms upon cessation (unlike bars, BDZ’s, and Z-drugs)
Buspirone
