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Phamacology Summer > Sedatives, Anxiolytics and Hypnotics > Flashcards

Sedatives, Anxiolytics and Hypnotics Flashcards

1
Q

Sleep, Sedation for a procedure, Seizure control

Sedatives, Anxiolytics, Hypnotics

A

Sedatives-

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2
Q

Sleep, Anxiety, Seizures, Sedation for a procedure

Sedatives, Anxiolytics, Hypnotics

A

Anxiolytics-

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3
Q

Purely intended for Sleep

Sedatives, Anxiolytics, Hypnotics

A

Hypnotics-

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4
Q

phenobarbital/methohexital ◦

Barbiturates, Benzodiazepines, Other Sedatives:

A

Barbiturates

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5
Q

Primidone

Barbiturates, Benzodiazepines, Other Sedatives

A

Barbiturates

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6
Q

diazepam, temazepam

Barbiturates, Benzodiazepines, Other Sedatives

A

Benzodiazepines

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7
Q

midazolam

Barbiturates, Benzodiazepines, Other Sedatives

A

Benzodiazepines

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8
Q

Chlordiazepoxide

Barbiturates, Benzodiazepines, Other Sedatives

A

Benzodiazepines

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9
Q

Opioids (Fentanyl), Propofol, Ketamine

Barbiturates, Benzodiazepines, Other Sedatives

A

Other Sedatives:

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10
Q

1 risk >Respiratory depression

Barbiturates, Benzodiazepines, Other Sedatives

A

Barbiturates

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11
Q 
USED TO TREAT
◦ Seizures
Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
A

Phenobarbital

Primidone

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12
Q

Anesthesia

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”

A

Methohexital

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13
Q

Alcohol withdrawal

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”

A

◦ “Phenobarbital Coma”

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14
Q

seizures only

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”

A

Primidone

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15
Q

(precursortophenobarbital)

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Primidone

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16
Q

Potentiate/amplifies the actions of GABA (gamma-amino-butyric acid), and directly mimic GABA (prolongs duration of chloride channel opening

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Methohexital
Phenobarbital
Primidone

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17
Q

ADVERSE EFFECTS
◦ Respiratory Depression
◦ #1 risk and reason why not commonly prescribed anymore.

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Methohexital
Phenobarbital
Primidone

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18
Q

CNS Depression
Confusion, drowsiness

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Methohexital
Phenobarbital
Primidone

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19
Q

paradoxical reactions (hyperactivity/anxiety)

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A 
Methohexital
Phenobarbital
Primidone
diazepam, temazepam
midazolam
Chlordiazepoxide
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20
Q

Cardiovascular
◦ sedative doses can cause lower BP (vasodilation) and HR
◦ toxic doses cause profound hypotension and shock

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A 
Methohexital
Phenobarbital
Primidone
diazepam, temazepam
midazolam
Chlordiazepoxide
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21
Q

Which should monitor for the following drugs- Methohexita, Phenobarbital, Primidone

MONITORING
◦ Watch respiratory rate
◦ Heart rate
◦ Blood pressure

A

All

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22
Q

TOXICITY- can present with hypotension, respiratory depression, CNS disturbances like nystagmus, ataxia

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Phenobarbital
Primidone
Methohexital

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23
Q

DRUG-DRUG INTERACTIONS
◦ These are CYP450 INDUCERS

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Phenobarbital
Primidone
Methohexital

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24
Q

REDUCES REM Sleep

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

Phenobarbital
Primidone
Methohexital

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25
Q

commonly used for sedation for procedures

Phenobarbital
Primidone
Methohexital

A

Methohexital-

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26
Q

commonly used for seizures and alcohol withdrawal

Phenobarbital
Primidone
Methohexital

A

Phenobarbital-

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27
Q

only for seizures

Phenobarbital
Primidone
Methohexital

A

Primidone- only for seizures

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28
Q

PANIC ATTACKS, PRN USAGE- NOT RECOMMENDED FOR CHRONIC THERAPY

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

diazepam, temazepam
midazolam
Chlordiazepoxide

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29
Q

Anxiety, MuscleSpasms ,Seizures(DiaSTAT®)

Diazepam
Midazolam
Temazepam
Chlordiazepoxide

A

Diazepam

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30
Q

Procedural-conscious sedation, anesthesia

Diazepam
Midazolam
Temazepam
Chlordiazepoxide

A

Midazolam

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31
Q

Sleep!PRN

Diazepam
Midazolam
Temazepam
Chlordiazepoxide

32
Q

Alcohol Withdrawal

Diazepam
Midazolam
Temazepam
Chlordiazepoxide

A

Chlordiazepoxide

33
Q

Muscle Spasms

Diazepam
Midazolam
Temazepam
Chlordiazepoxide

34
Q

MECHANISM OF ACTION:
potentiate/amplifies the actions of GABA (gamma-amino-butyric acid), does NOT directly mimic GABA

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
A

diazepam, temazepam
midazolam
Chlordiazepoxide

35
Q

induces muscle relaxation through effects on ?

  • premotor cortex
  • supraspinal motor areas
  • cortical areas
  • hippocampus
A

supraspinal motor areas

36
Q

Hangover effect! Can see drowsiness the next day

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

diazepam, temazepam
midazolam
Chlordiazepoxide

37
Q

is use for SEDATION for PROCEDURES

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
38
Q

MIDAZOLAM acts on ? and cerebral cortex and this is why we see confusion, and anterograde amnesia

  • premotor cortex
  • supraspinal motor areas
  • cortical areas
  • hippocampus
A

hippocampus

39
Q

Which are the main concerns for ALCOHOL WITHDRAWAL

-DeliriumTremens(DT’s)
-Seizures
-Neurological Toxicity
-too much Glutamate
-too less Glutamate
-Wernicke encephalopathy
-Korsakoff Syndrome
All
None

A
  • DeliriumTremens(DT’s)
  • Seizures
  • Neurological Toxicity
  • Wernicke encephalopathy
  • Korsakoff Syndrome
  • too much Glutamate
40
Q

TREATMENT for ALCOHOL WITHDRAWAL

Phenobarbital
Primidone
Methohexital
lorazepam
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A 
Phenobarbital
diazepam
lorazepam
Chlordiazepoxide
Multivitamin, Thiamine and Folic Acid
41
Q

IV combination commonly referred to as “Banana Bag” based on its color (ironically, no potassium in it!)

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

Multivitamin, Thiamine and Folic Acid

42
Q

◦ Paradoxical effects ?

insomnia
anxiety
rage
SLUDGE

A

insomnia,
anxiety,
rage

43
Q

◦ cardiovascular- profound hypotension (IV)

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

diazepam, temazepam
midazolam
Chlordiazepoxide

44
Q

respiratory depression with high dose (IV) combined with other drugs

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

diazepam, temazepam
midazolam
Chlordiazepoxide

45
Q

Tolerance- patients may need higher doses overtime to have same effect

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

diazepam, temazepam
midazolam
Chlordiazepoxide

46
Q

◦ Dependency!- Very real and hard to taper off

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

diazepam, temazepam
midazolam
Chlordiazepoxide

47
Q

hangover effect, day time drowsiness (especially if long half life)

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Multivitamin, Thiamine and Folic Acid
A

diazepam, temazepam
midazolam
Chlordiazepoxide

48
Q

◦ Sudden stoppage- Withdrawal- ^^ SEIZURES

T or F

49
Q

◦ Sudden stoppage of alcohol= seizures

T or F

50
Q

◦ Sudden stoppage of Benzodiazepines= seizures

T or F

51
Q

◦ Sudden stoppage of Barbiturates= seizures

T or F

52
Q

ANTIDOTEReversal Agent =Flumazenil for ? because of ?

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Buspirone
A

diazepam, temazepam
midazolam
Chlordiazepoxide

Seizures

53
Q

flumazenil can induce seizures due to withdrawal

T or F

54
Q

An acute attack (panic/anxiety)

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Buspirone
A

diazepam, temazepam
midazolam
Chlordiazepoxide

55
Q

CHRONIC THERAPY
◦ Antidepressants

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Buspirone
56
Q

USED TO TREAT:
◦ Generalized Anxiety Disorder

Phenobarbital
Primidone
Methohexital
“Phenobarbital Coma”
diazepam, temazepam
midazolam
Chlordiazepoxide
Opioids (Fentanyl), Propofol, Ketamine
Buspirone
57
Q

Buspirone is Chronic or Acute Therapy

58
Q

High risk for Respiratory Depression

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
A

phenobarbital

59
Q

▪ Less risk for respiratory Depression

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
60
Q

Benzodiazepine Like Agents

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
A

Zolpidem Tartrate

61
Q

Melatonin Agonist

Is this a controlled or not controlled substance?

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
62
Q

HERBALS

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
A

Kava, Valerian Root

63
Q

Short term treatment of Insomnia

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
64
Q

sedative hypnotic ONLY

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
65
Q

hangover effect

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
66
Q

Administer at bedtime (should have at least 8 hours of time set aside)

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
67
Q

Take on empty stomach (do not give with or immediately after a meal) alters onset

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
68
Q

Avoid alcohol, or CNS Depressants

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
69
Q

Alters REMS sleep

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
70
Q

SHORT TERM THERAPY ONLY

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
71
Q

Only meant to help with Difficulty Falling Asleep

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
72
Q

Hospital induced Delirium

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
73
Q

Use
◦ Promotes sleep and decreases anxiety

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
74
Q

Associated with liver damage including liver failure

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
75
Q

Kava

Liver or Kidney damage

76
Q

◦ Promotes sleep only

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
A

Valerian Root

77
Q

Increases GABA

phenobarbital
temazepam
Zolpidem Tartrate
Ramelteon
Kava, Valerian Root
A

Valerian Root

Phamacology Summer (48 decks)

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