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Pharm III Unit 1 > Sedative-Hypnotics and Anxiolytics > Flashcards

Sedative-Hypnotics and Anxiolytics Flashcards

1
Q

Primary use of sedative-hypnotic and anxiolytic drugs

A

KEEP CALM SLEEP ON

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2
Q

Adaptive anxiety disorder

A

Appropriate rxn to danger; increase sympathetic activity

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3
Q

Maladaptive anxiety disorder

A

Chronic, psychological stress –> lead to organ dysfxn (GI, cardiac), physical sxs

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4
Q

Ideal anti-anxiety drug

A

Relieve anxiety w/o sedation or drowsiness; no physical or psychological dependence

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5
Q

DOC for enuresis

A

TCA

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6
Q

Sleep disorder that the gf has

A

Kleine-Levin syndrome “Sleeping beauty”

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7
Q

Tx transient or short-term insomnia

A

Sedative hypnotic

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8
Q

Tx for hypersomnia, narcolepsy

A

Stimulants

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9
Q

Tx for sleep apnea

A

CPAP and lifestyle changes

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10
Q

Ideal sedative hypnotic

A

fall asleep quickly, stay asleep, no hangover (everything i cannot do)

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11
Q

Long-term insomnia causes and tx

A

underlying psych or chronic alcohol drug abuse; treat w/ behavioral therapy and lifestyle

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12
Q

GABA receptor that decreases anxiety and promotes sleep

A

GABA(a)

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13
Q

Antihistamine used as anti-anxiety med and causes sedation

A

hydroxyzine

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14
Q

MOA of Barbiturates

A

Binds to GABA receptor –> stimulate Cl- influx –> inhibit INDEPENDENT of GABA

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15
Q

Barbiturates uses

A 
Short-acting = induction of anesthesia
Long-acting = anticonvulsants
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16
Q

Barb for induction of anesthesia

A

Thiopental (short-acting)

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17
Q

Barb for anticonvulsant

A

Phenobarbital (long-acting)

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18
Q

Barb metabolized by

A

liver

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19
Q

Barbiturates side effects

A

CNS depression, paradoxical excitement, may depress vasomotor and respiratory centers in medulla

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20
Q

Barbs contraindications

A

Porphyria, pulmonary insufficiency, supra-additive effects

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21
Q

No “ceiling effect”; low margin of safety, supra-addictve

A

Barbiturates

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22
Q

tx of barbiturates overdose

A

Supportive, clear w/ diuresis and alkalization of urine (also do not give stimulants!)

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23
Q

who does not metabolize BZs as quickly

A

old people

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24
Q

Benzo metabolized by

A

CYP3A4

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25
Q

Benzo w/ long duration of action

A

Diazepam, flurazepam

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26
Q

Benzo w/ intermediate duration of action

A

Alprazolam, oxazepam/lorazepam

27
Q

Benzo w/ short duration of action

A

Midazolam

28
Q

Ceiling effect

A

Benzo

29
Q

DOC for anxiety disorders

A

Benzo (use effective dose for shortest duration possible)

30
Q

DOC for OCD

A

SSRI

31
Q

DOC for agoraphobia

A

SSRI

32
Q

DOC for panic disorder

A

SSRI

33
Q

DOC for PTSD

A

antidepressant

34
Q

DOC for anxiety in children and adolescent

A

antidepressant

35
Q

Benzo drugs for insomnia b/c shorter-acting

A

Flurazepam and temazepam

36
Q

Benzo drug for status epilepticus

A

Diazepam and lorazepam

37
Q

Benzo drug used for anesthesia prep for short surgical procedure

A

Midazolam

38
Q

Causes anterograde amnesia

A

Midazolam

39
Q

Route for midazolam

A

IV

40
Q

Muscle relaxation benzo drug

A

Diazepam

41
Q

Drugs to provide more tapered withdrawal for alcohol and barb withdrawal

A

chlordiazepoxide, diazepam, lorazepam

42
Q

Benzo antagonist

A

Flumazenil

43
Q

Pt w/ respiratory depression due to taking midazolam for an anesthesia procedure, what you be do

A

Flumazenil

44
Q

Do not use flumazenil if pt w/

A

hx of seizure

45
Q

Them Z-drugs

A

Zolpidem, Zaleplon, Eszopiclone

46
Q

Z-drugs MOA

A

bind to GABA receptor at BZ1 –> increase GABA mediated inhibition

47
Q

Z-drugs are used for

A

insomnia

48
Q

Z-drugs have no affects on which properties

A

No anxiolytic, anticonvulsant, or muscle relaxant properties

49
Q

Which Z-drug has a long half life

A

Eszopiclone

50
Q

Do not use Suvorexant if your pt has

A

narcolepsia

51
Q

MOA of suvorexant

A

Antagonist at orexin receptor

52
Q

Melatonin analogue

A

Ramelteon

53
Q

Resets sleep-wake cycle

A

Ramelteon

54
Q

A pt w/ occasional insomnia w/ a hx of addiction. What do you give

A

knock them out with some diphenhydramine

55
Q

Chloral hydrate converts to

A

Trichloroethanol

56
Q

Chloral hydrate MOA

A

similar to barbs on GABA(a) receptor

57
Q

Long term use of chloral hydrate causes

A

liver damage and fetal intoxication

58
Q

Relieves anxiety w/o producing sedation

A

Buspirone

59
Q

MOA of Buspirone

A

Partial agonist at postsynaptic 5-HT1A receptor; full agonist for presynaptic 5-HT1A receptor

60
Q

Buspirone has no effect on which properties

A

muscle relaxant or anticonvulsant properties

61
Q

Drugs that works independently of GABA

A

Ramelteon, Buspirone, Suvorexant, Barbiturates

62
Q

Benzo Contraindication

A

Preggo, sleep apnea, elderly

63
Q

A pt comes in for scaring the shit out of their lesbian partner because they’ve been sleep walking, eating, and driving. You proceed to review their drugs, what are you likely to find them taking?

A

Benzos or z-drugs

Pharm III Unit 1 (9 decks)

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