Sedatives and Hypnotics Flashcards
2 examples of fast acting benzodiazepines
alprazolam(xanax)
Diazepam(valium)
Benzodiazepines MOA
Binda GABAa receptors
potentiates GABA through increased chloride conductance: increases the frequency of chnnel-opening events
when would benzodiazepines and barbiturates not be recommended?
in breathing related sleep disorders: risk of respiratory depression
benzodiazepines therapeutic uses
acute anxiety
panic disorder
sleep disorder:caution in obstructive sleep apnea
iv anesthesia
anticonvulsant
muscle relaxant
alcohol withdrawal
benzodiazepines adverse effects
-drowsiness, sedation, mental confusion, disorientation
-ataxia, weakness, amnesia (date rape drug), hypnosis
sleep disturbance
overdsoe
interactions with alcohol and other sedatives
dependence and addiction
BZD withdrawal
slow taper necessary
decrease dose by 25% per week, until 50% of the dose is reached, then dose 1/8 every 4-7 days `
BZD antagonist drug
flumazenil
reverses BZD action
Buspirone uses
anxiolytic in mild chronic anxiety and GAD
takes 3-4 wks to work
Buspirone MOA
partial agonist at 5-HT receptors, possibly D2 receptors
Buspirone AE
Slow onset
GI tract upset, dizziness, drowsiness
not effective in severe anxiety/panic disorders
drug interactions with CYT P450 inducers and inhibitors
which BZD are best used for panic attacks
alprazolam and clonazepam
they have a short onset
which BZD are safe for patients with liver problems
lorazepam and oxazepam
undergo extrahepatic conjugation and do not form active metabolites
which. BZD causes the most severe respiratory depression
alprazolam (xanax)
______. will affect phases or pattern of sleep and can cause nightmares
barbiturates
Zolpidem (ambien) use
sleep disordersd, esp when sleep onset is delyaed
