Sedatives, Anxiolytics, and Amnestics Flashcards
What are the main indications for sedatives, anxiolytics, and amnestics?
Treatment of mental disorders, epilepsy, muscle tension, sleep disorders, and induction/maintenance of anesthesia.
What is the primary mechanism of benzodiazepines?
They enhance GABA affinity but do not directly activate receptors.
What are the common agents used in perioperative benzodiazepines?
Diazepam (Valium), Midazolam (Versed), Lorazepam (Ativan).
What is the pharmacokinetics of Midazolam?
Onset: 30 sec-1 min, Peak: 3-5 min, Duration: 15-80 min.
What is the half-life of Lorazepam?
6-10 hours.
What are the adverse effects of benzodiazepines?
Respiratory depression, cardiovascular depression, tolerance, and dependence.
What is the dosing consideration for Midazolam in elderly patients?
Decrease dose by 25-50%.
What is Flumazenil used for?
It is a benzodiazepine antagonist used for reversal of sedation.
What is the onset and peak effect of Byfavo (Remimazolam)?
Onset: 1.6 min, Peak: 3-3.5 min.
What are the pharmacokinetics of Diazepam?
Onset: rapid 60 seconds IV, Peak: 3-4 min, Duration: 1-6 hours.
What should be considered when dosing benzodiazepines in obese patients?
Increase dose due to delayed emergence.
What is the effect of opioids on benzodiazepines?
They can cause synergistic effects, increasing sedation but potentially antagonizing analgesic properties.
What is the duration of action for Flumazenil?
45-90 min.
What are the potential adverse events of Byfavo?
Hypotension, hypertension, and hypoxia.
What is the metabolism of Midazolam affected by?
Drugs that inhibit P450 and renal failure.
What is the significance of the alpha subtypes of GABA_A receptors?
Different subtypes are associated with various effects such as sedation, anxiolysis, and muscle relaxation.
